Provider Demographics
NPI:1720746456
Name:KRETSCHY, LINDSEY (MPS, ATR-BC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:KRETSCHY
Suffix:
Gender:F
Credentials:MPS, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 NAVAJO TRL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-1515
Mailing Address - Country:US
Mailing Address - Phone:908-963-2922
Mailing Address - Fax:
Practice Address - Street 1:2 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2460
Practice Address - Country:US
Practice Address - Phone:908-963-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty