Provider Demographics
NPI:1164818738
Name:FOSTER, LYNN F (OTR/L)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:F
Last Name:FOSTER
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 1:6859 ROSEBUD WAY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1531
Mailing Address - Country:US
Mailing Address - Phone:937-898-0518
Mailing Address - Fax:
Practice Address - Street 1:1120 DUNAWAY ST
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3839
Practice Address - Country:US
Practice Address - Phone:937-866-9089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00156225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist