Provider Demographics
NPI:1548913072
Name:POWELL, LINDY ANN (LSLS CERT AVED)
Entity type:Individual
Prefix:
First Name:LINDY
Middle Name:ANN
Last Name:POWELL
Suffix:
Gender:F
Credentials:LSLS CERT AVED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9192 WALDEMAR RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1131
Mailing Address - Country:US
Mailing Address - Phone:131-747-1856
Mailing Address - Fax:
Practice Address - Street 1:9192 WALDEMAR RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1131
Practice Address - Country:US
Practice Address - Phone:131-747-1856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist