Provider Demographics
NPI:1427275296
Name:LIND, MIA (OTR-L)
Entity type:Individual
Prefix:MRS
First Name:MIA
Middle Name:
Last Name:LIND
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:GEORGINA 1653
Mailing Address - Street 2:REPARTO DE DIEGO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-763-7521
Mailing Address - Fax:787-763-2480
Practice Address - Street 1:GEORGINA 1653
Practice Address - Street 2:REPARTO DE DIEGO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-763-7521
Practice Address - Fax:787-763-2480
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR796225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist