Provider Demographics
NPI:1144793704
Name:SCHROEDER, LINDSAY CLAIRE (OTRL)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:CLAIRE
Last Name:SCHROEDER
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:C
Other - Last Name:MATHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1720 LIBERTY PIKE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8501
Mailing Address - Country:US
Mailing Address - Phone:616-550-5690
Mailing Address - Fax:
Practice Address - Street 1:1117 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-3072
Practice Address - Country:US
Practice Address - Phone:616-550-5690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5984225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN83-3035740OtherEINS