Provider Demographics
NPI:1609605815
Name:SOBANIA, LINDSEY LUCILLE (CNA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:LUCILLE
Last Name:SOBANIA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16648 177TH AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-5528
Mailing Address - Country:US
Mailing Address - Phone:320-431-9076
Mailing Address - Fax:
Practice Address - Street 1:4140 RICHARD AVE STE 200&300
Practice Address - Street 2:
Practice Address - City:HERMANTOWN
Practice Address - State:MN
Practice Address - Zip Code:55811-2869
Practice Address - Country:US
Practice Address - Phone:218-514-5230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician