Basic Information
| Provider Information | |||||||||
| NPI: | 1376105437 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GINGERICH | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | BROOKE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OTR | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GRABER | ||||||||
| OtherFirstName: | LINDSEY | ||||||||
| OtherMiddleName: | BROOKE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 118 MEDICAL DR | ||||||||
| Address2: | |||||||||
| City: | CARMEL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460323323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175731037 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7231 BLEDSOE LN | ||||||||
| Address2: | |||||||||
| City: | LOOGOOTEE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124866440 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2019 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 31006805A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.