Provider Demographics
NPI:1962667196
Name:LUTMAN, ALICIA LYNN (OTD, MS, OTR/L, ATC)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:LYNN
Last Name:LUTMAN
Suffix:
Gender:F
Credentials:OTD, MS, OTR/L, ATC
Other - Prefix:MS
Other - First Name:ALICIA
Other - Middle Name:LYNN
Other - Last Name:TROYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, MS,OTR/L, ATC
Mailing Address - Street 1:600 N MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664-1855
Mailing Address - Country:US
Mailing Address - Phone:540-459-6222
Mailing Address - Fax:
Practice Address - Street 1:600 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1855
Practice Address - Country:US
Practice Address - Phone:540-459-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004262225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist