Provider Demographics
NPI:1992560932
Name:VICKERS, LYNDSEY K
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:K
Last Name:VICKERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:K
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:344 W HIGH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-2152
Mailing Address - Country:US
Mailing Address - Phone:330-339-7850
Mailing Address - Fax:330-339-7844
Practice Address - Street 1:344 W HIGH AVE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-2152
Practice Address - Country:US
Practice Address - Phone:330-339-7850
Practice Address - Fax:330-339-7844
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator