Provider Demographics
NPI:1114498847
Name:GOINS, LINDSEY MARIA (OT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIA
Last Name:GOINS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:MARIA
Other - Last Name:KOOVACKAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:3300 RIVERMONT AVE
Mailing Address - Street 2:CENTRA OUTPATIENT REHAB ADMIN
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-2030
Mailing Address - Country:US
Mailing Address - Phone:434-200-5032
Mailing Address - Fax:434-200-3003
Practice Address - Street 1:693 LEESVILLE RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-2828
Practice Address - Country:US
Practice Address - Phone:434-200-5032
Practice Address - Fax:434-200-3003
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2018-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007840225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist