Provider Demographics
NPI:1194965780
Name:WEIDLING, LANA Y (OTR)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:Y
Last Name:WEIDLING
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4544 S LAMAR BLVD
Mailing Address - Street 2:SUITE 750
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1500
Mailing Address - Country:US
Mailing Address - Phone:512-892-7900
Mailing Address - Fax:512-280-9298
Practice Address - Street 1:4544 S LAMAR BLVD
Practice Address - Street 2:SUITE 750
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1500
Practice Address - Country:US
Practice Address - Phone:512-892-7900
Practice Address - Fax:512-280-9298
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60270969225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist