Provider Demographics
NPI:1043993579
Name:PALMER, LINDSEY BROOKE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:BROOKE
Last Name:PALMER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 BOSCHERT DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-7205
Mailing Address - Country:US
Mailing Address - Phone:636-793-6610
Mailing Address - Fax:
Practice Address - Street 1:1113 BOSCHERT DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-7205
Practice Address - Country:US
Practice Address - Phone:636-793-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022025545224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant