Provider Demographics
NPI:1124599626
Name:BROWN, LYNN ANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANNE
Last Name:BROWN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21745 DALEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3901
Mailing Address - Country:US
Mailing Address - Phone:610-348-1674
Mailing Address - Fax:
Practice Address - Street 1:17410 COLLEGE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2369
Practice Address - Country:US
Practice Address - Phone:877-270-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-09
Last Update Date:2018-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201010083225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist