Provider Demographics
NPI:1386081958
Name:RIDDLE, LINDA BETH LEWIS (OTR/L)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:BETH LEWIS
Last Name:RIDDLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 DANIEL DR
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-5235
Mailing Address - Country:US
Mailing Address - Phone:802-479-6952
Mailing Address - Fax:
Practice Address - Street 1:28 DANIEL DR
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-5235
Practice Address - Country:US
Practice Address - Phone:802-479-6952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072-0000286225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist