Provider Demographics
NPI:1316298557
Name:ALLEN, LINDA LOU (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LOU
Last Name:ALLEN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 ROLLING HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:OH
Mailing Address - Zip Code:45885-9240
Mailing Address - Country:US
Mailing Address - Phone:419-394-3560
Mailing Address - Fax:
Practice Address - Street 1:625 ROLLING HILLS DR
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:OH
Practice Address - Zip Code:45885-9240
Practice Address - Country:US
Practice Address - Phone:419-394-3560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA 04751390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program