Lynne Anne White, OTR

Individual provider Active NPI Neurorehabilitation Occupational Therapist · Jefferson, MO

NPI 1255487948 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1255487948
Entity type
Individual (NPI type 1)
Primary specialty
Neurorehabilitation Occupational Therapist 225XN1300X
License
001013 (MO)
Practice address
1125 Madison
Jefferson, MO 65102-1128
Phone
(573) 632-5628
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
001013MOMDNeurorehabilitation Occupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X 001013 MO Yes

Addresses

Primary practice location

1125 Madison
Jefferson, MO 65102-1128

Mailing address

3525 Gettysburg PL
Jefferson City, MO 65109-6831
Phone (573) 893-5281

Other providers in Jefferson, MO

All providers in Jefferson, MO · Neurorehabilitation Occupational Therapist in Missouri

Sources for this page

Verify at the official NPI Registry.