Basic Information
Provider Information
NPI: 1437195690
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRINSTEAD
FirstName: LINDA
MiddleName: I
NamePrefix: MS.
NameSuffix:  
Credential: MS, OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 150 WAYLAND SMITH DR
Address2: SUITE A
City: UNIONTOWN
State: PA
PostalCode: 154012677
CountryCode: US
TelephoneNumber: 7244378200
FaxNumber: 7244376673
Practice Location
Address1: 150 WAYLAND SMITH DR
Address2: SUITE A
City: UNIONTOWN
State: PA
PostalCode: 154012677
CountryCode: US
TelephoneNumber: 7244378200
FaxNumber: 7244376673
Other Information
ProviderEnumerationDate: 06/22/2006
LastUpdateDate: 10/14/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOC0045851PAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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