Provider Demographics
NPI:1124334420
Name:LINDLAND, KIMBERLY JAYNE (MA OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JAYNE
Last Name:LINDLAND
Suffix:
Gender:F
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:LINDLAND CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023
Mailing Address - Country:US
Mailing Address - Phone:908-322-2487
Mailing Address - Fax:
Practice Address - Street 1:313 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:FANWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07023
Practice Address - Country:US
Practice Address - Phone:908-889-5860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00322400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist