Provider Demographics
NPI:1780810077
Name:POWELL, LINDSEY ERIN (COTA/L)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ERIN
Last Name:POWELL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ERIN
Other - Last Name:COREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:2485 CRESCENZIO WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8669
Mailing Address - Country:US
Mailing Address - Phone:502-298-1137
Mailing Address - Fax:
Practice Address - Street 1:1979 LAKESIDE PKWY
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5935
Practice Address - Country:US
Practice Address - Phone:770-325-0310
Practice Address - Fax:770-908-2203
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA3611224Z00000X
IN32001706A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant