Provider Demographics
NPI:1962921296
Name:SCHAFER, LYNSEY THERESA (OTR/L)
Entity type:Individual
Prefix:
First Name:LYNSEY
Middle Name:THERESA
Last Name:SCHAFER
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 1:11420 BLONDO ST STE 103
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-3858
Mailing Address - Country:US
Mailing Address - Phone:413-887-7409
Mailing Address - Fax:
Practice Address - Street 1:59 BLACKSTOCK RD
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:SC
Practice Address - Zip Code:29349-1827
Practice Address - Country:US
Practice Address - Phone:864-472-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-19
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14309225X00000X
SC6394225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist