Provider Demographics
NPI:1396060091
Name:PATTY, LYNNE LAURENCE (OT)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:LAURENCE
Last Name:PATTY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3230 LAKE WORTH RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3694
Mailing Address - Country:US
Mailing Address - Phone:561-968-7788
Mailing Address - Fax:561-968-9969
Practice Address - Street 1:3230 LAKE WORTH RD
Practice Address - Street 2:SUITE C
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3694
Practice Address - Country:US
Practice Address - Phone:561-968-7788
Practice Address - Fax:561-968-9969
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1432172M00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No172M00000XOther Service ProvidersMechanotherapist