Provider Demographics
NPI:1962525246
Name:FLYNN, LINDA SUSAN (OTR)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SUSAN
Last Name:FLYNN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7611 ELMWOOD AVE
Mailing Address - Street 2:STE. 101
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-3161
Mailing Address - Country:US
Mailing Address - Phone:608-831-2511
Mailing Address - Fax:608-824-8903
Practice Address - Street 1:7611 ELMWOOD AVE
Practice Address - Street 2:STE. 101
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3161
Practice Address - Country:US
Practice Address - Phone:608-831-2511
Practice Address - Fax:608-824-8903
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1276-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist