Provider Demographics
NPI:1588334015
Name:KOUSAIE, LINDSEY ELISE (OTR/L)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ELISE
Last Name:KOUSAIE
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 1:51 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5849
Mailing Address - Country:US
Mailing Address - Phone:207-717-4554
Mailing Address - Fax:
Practice Address - Street 1:1222 PORTLAND RD
Practice Address - Street 2:SUITE 10
Practice Address - City:ARUNDEL
Practice Address - State:ME
Practice Address - Zip Code:04046
Practice Address - Country:US
Practice Address - Phone:207-337-1058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT4154225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics