| Doctor Name: | DR. LINDSAY BENNIGSON JERNIGAN |
| NPI Number: | 1093990632 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D., M.A. |
| License Number: | 048.0056429 |
| Business Practice Address: | 185 Tilley Dr Suite 14 South Burlington, VT - 054034484 |
| Business Phone Number: | 8022298270 |
| Business Fax Number: | 8028628411 |
| Mailing Address: | 185 Tilley Dr, Suite 14 SOUTH BURLINGTON |
| State: | VT |
| Postal Code: | 054034484 |
| Phone Number: | 8022298270 |
| Fax Number: | 8028628411 |
| NPI Enumeration Date: | 01/02/2008 |
| NPI Last Update Date: | 09/03/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 048.0056429 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |