Provider Demographics
NPI:1932590155
Name:MARTIN, LINDSEY TAYLOR (OTR/L)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:TAYLOR
Last Name:MARTIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:TAYLOR
Other - Last Name:CAMDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2538 N HAZELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-2411
Mailing Address - Country:US
Mailing Address - Phone:630-747-0668
Mailing Address - Fax:
Practice Address - Street 1:2538 N HAZELWOOD ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-2411
Practice Address - Country:US
Practice Address - Phone:630-747-0668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02787225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist