Provider Demographics
NPI:1588250823
Name:CASEY, LYNSEY MARIE (COTA/L)
Entity type:Individual
Prefix:
First Name:LYNSEY
Middle Name:MARIE
Last Name:CASEY
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 1:902 OLMSTED CT
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-2474
Mailing Address - Country:US
Mailing Address - Phone:317-642-7333
Mailing Address - Fax:
Practice Address - Street 1:958 STATE ROAD 46 E
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7600
Practice Address - Country:US
Practice Address - Phone:812-934-2436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-20
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002934AQ224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant