Provider Demographics
NPI:1902956162
Name:EVANS, LINDSAY MARIE (OTR)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:MARIE
Last Name:EVANS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MARIE
Other - Last Name:CORSTANGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:416 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3934
Mailing Address - Country:US
Mailing Address - Phone:410-889-0727
Mailing Address - Fax:410-889-0729
Practice Address - Street 1:915 FOLLY RD STE A1
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3907
Practice Address - Country:US
Practice Address - Phone:410-889-0727
Practice Address - Fax:410-889-0729
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT2048225X00000X
SC4626225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist