Basic Information
| Provider Information | |||||||||
| NPI: | 1437453370 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPENCER | ||||||||
| FirstName: | LYNDSY | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1420 16TH ST SW | ||||||||
| Address2: | |||||||||
| City: | WILLMAR | ||||||||
| State: | MN | ||||||||
| PostalCode: | 562012828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3204204080 | ||||||||
| FaxNumber: | 3207642245 | ||||||||
| Practice Location | |||||||||
| Address1: | 2120 60TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | WILLMAR | ||||||||
| State: | MN | ||||||||
| PostalCode: | 562019140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3202147082 | ||||||||
| FaxNumber: | 3202358059 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2011 | ||||||||
| LastUpdateDate: | 01/07/2011 | ||||||||
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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 | 103917 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.