Provider Demographics
NPI:1144706789
Name:MOORE, LINDSEY BROOKE (COTA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:BROOKE
Last Name:MOORE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16466 ZEHNER RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-8398
Mailing Address - Country:US
Mailing Address - Phone:256-777-9142
Mailing Address - Fax:
Practice Address - Street 1:16466 ZEHNER RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-8398
Practice Address - Country:US
Practice Address - Phone:256-777-9142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant