Provider Demographics
NPI:1144633918
Name:HARWELL, LYNN (OTR)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:HARWELL
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 1:685 CARMEL LN
Mailing Address - Street 2:
Mailing Address - City:POINCIANA
Mailing Address - State:FL
Mailing Address - Zip Code:34759-6119
Mailing Address - Country:US
Mailing Address - Phone:347-752-3071
Mailing Address - Fax:
Practice Address - Street 1:625 OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-1626
Practice Address - Country:US
Practice Address - Phone:863-229-5994
Practice Address - Fax:863-662-3926
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13129225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist