Provider Demographics
NPI:1043322340
Name:ATHEY, LYNN DENISE (OTR)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:DENISE
Last Name:ATHEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 DELMONT CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3175
Mailing Address - Country:US
Mailing Address - Phone:210-481-5178
Mailing Address - Fax:
Practice Address - Street 1:5121 CRESTWAY DR
Practice Address - Street 2:SUITE507
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-1980
Practice Address - Country:US
Practice Address - Phone:210-646-8008
Practice Address - Fax:210-646-8242
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111427225XN1300X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75285003678239A016OtherTRICARE
TX8T4103OtherBCBS