Provider Demographics
NPI:1164679577
Name:CROUCH, LYNDA ELAINE (MOT,OTR/L, ATP)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:ELAINE
Last Name:CROUCH
Suffix:
Gender:F
Credentials:MOT,OTR/L, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N PHILLIPS AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-4619
Mailing Address - Country:US
Mailing Address - Phone:405-271-3625
Mailing Address - Fax:405-271-1707
Practice Address - Street 1:1600 N PHILLIPS AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4619
Practice Address - Country:US
Practice Address - Phone:405-271-3625
Practice Address - Fax:405-271-1707
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT551225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist