Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 005608-1 | NY |
NPI | 1023314242 |
---|---|
Provider Name | Mrs. Kathleen Ann Lindquist |
First Address | Wantagh, NY 11793-3830 |
Second Address | Commack, NY 11725-5612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2011 |
Last Update Date | 04/02/2011 |