Provider Demographics
NPI:1902812241
Name:THORPE, LYDIA JENSEN (OCC THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:JENSEN
Last Name:THORPE
Suffix:
Gender:F
Credentials:OCC THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7520 BANCASTER DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5715
Mailing Address - Country:US
Mailing Address - Phone:317-876-3558
Mailing Address - Fax:317-876-3568
Practice Address - Street 1:7520 BANCASTER DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-5715
Practice Address - Country:US
Practice Address - Phone:317-876-3558
Practice Address - Fax:317-876-3568
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002099A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist