Provider Demographics
NPI:1588973598
Name:LINDAHL, GAIL MAGDALENE (OTR/L)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:MAGDALENE
Last Name:LINDAHL
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 1:2661 W. AUGUSTA DR.
Mailing Address - Street 2:#29
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-1661
Mailing Address - Country:US
Mailing Address - Phone:928-782-1856
Mailing Address - Fax:
Practice Address - Street 1:2661 W AUGUSTA DR
Practice Address - Street 2:#29
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-1661
Practice Address - Country:US
Practice Address - Phone:928-782-1856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-26
Last Update Date:2010-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4436225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist