Provider Demographics
NPI:1932335528
Name:WINTERS, LYNN P (OTR/L)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:P
Last Name:WINTERS
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 1:298 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:SEBEC
Mailing Address - State:ME
Mailing Address - Zip Code:04481-3011
Mailing Address - Country:US
Mailing Address - Phone:207-564-7259
Mailing Address - Fax:
Practice Address - Street 1:298 NORTH RD
Practice Address - Street 2:
Practice Address - City:SEBEC
Practice Address - State:ME
Practice Address - Zip Code:04481-3011
Practice Address - Country:US
Practice Address - Phone:207-564-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT00000125225X00000X, 225XP0019X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME433373600Medicaid