Provider Demographics
NPI:1366302473
Name:MANUAL LYMPHATIC DRAINAGE & LYMPHEDEMA OCCUPATIONAL THERAPY, PLLC
Entity type:Organization
Organization Name:MANUAL LYMPHATIC DRAINAGE & LYMPHEDEMA OCCUPATIONAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:LOMBARDO
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:860-402-0184
Mailing Address - Street 1:14 LEACH HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:CT
Mailing Address - Zip Code:06784-2300
Mailing Address - Country:US
Mailing Address - Phone:860-402-0184
Mailing Address - Fax:860-402-0184
Practice Address - Street 1:14 LEACH HOLLOW RD
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:CT
Practice Address - Zip Code:06784-2300
Practice Address - Country:US
Practice Address - Phone:860-402-0184
Practice Address - Fax:860-402-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty