Basic Information
| Provider Information | |||||||||
| NPI: | 1174930580 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HART | ||||||||
| FirstName: | LINDSAY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1060 WILLOW GROVE CT | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483072546 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2387 E WALTON BLVD | ||||||||
| Address2: | |||||||||
| City: | AUBURN HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483261955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484756400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2014 | ||||||||
| LastUpdateDate: | 07/17/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | MI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.