Provider Demographics
NPI:1114158417
Name:THOMAS, LINDA REANEE (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:REANEE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:REANEE
Other - Last Name:CITCHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:428 S BARNEWOLT DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61604-5910
Mailing Address - Country:US
Mailing Address - Phone:309-671-4211
Mailing Address - Fax:
Practice Address - Street 1:15 BRONZE POINTE N
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1007
Practice Address - Country:US
Practice Address - Phone:618-235-6814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056 003306225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist