Provider Demographics
NPI:1154704526
Name:HOPKINS, LYNETTE (COTA/L, CLT)
Entity type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:COTA/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23444 TYPO CREEK DR NE
Mailing Address - Street 2:
Mailing Address - City:STACY
Mailing Address - State:MN
Mailing Address - Zip Code:55079-9347
Mailing Address - Country:US
Mailing Address - Phone:763-229-0112
Mailing Address - Fax:
Practice Address - Street 1:23444 TYPO CREEK DR NE
Practice Address - Street 2:
Practice Address - City:STACY
Practice Address - State:MN
Practice Address - Zip Code:55079-9347
Practice Address - Country:US
Practice Address - Phone:763-229-0112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-03
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN201794224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant