Provider Demographics
NPI:1902449457
Name:MUNOZ, LYNDSAY MARIE
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:MARIE
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 W VILLAS DR
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49097-9627
Mailing Address - Country:US
Mailing Address - Phone:330-749-0427
Mailing Address - Fax:
Practice Address - Street 1:1003 W VILLAS DR
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MI
Practice Address - Zip Code:49097-9627
Practice Address - Country:US
Practice Address - Phone:330-749-0427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst