Provider Demographics
NPI:1063944239
Name:HALL, LINDSEY ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:HALL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PARKSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-8012
Mailing Address - Country:US
Mailing Address - Phone:307-214-9989
Mailing Address - Fax:
Practice Address - Street 1:1211 S DOUGLAS HWY
Practice Address - Street 2:SUITE 130
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-4949
Practice Address - Country:US
Practice Address - Phone:307-763-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY743LP225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist