Provider Demographics
NPI:1194393553
Name:MUSSELMAN, LYNN RENE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:RENE
Last Name:MUSSELMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 WHISPERING PINES LN
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:FL
Mailing Address - Zip Code:32949-2304
Mailing Address - Country:US
Mailing Address - Phone:321-427-2027
Mailing Address - Fax:
Practice Address - Street 1:6675 WHISPERING PINES LN
Practice Address - Street 2:
Practice Address - City:GRANT
Practice Address - State:FL
Practice Address - Zip Code:32949-2304
Practice Address - Country:US
Practice Address - Phone:321-427-2027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty