Provider Demographics
NPI:1215231816
Name:DEAN, LINDSAY BROOKE (BA, COTA/L)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:BROOKE
Last Name:DEAN
Suffix:
Gender:F
Credentials:BA, COTA/L
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:545 VERDAE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-4021
Mailing Address - Country:US
Mailing Address - Phone:864-520-8910
Mailing Address - Fax:864-520-8912
Practice Address - Street 1:545 VERDAE BLVD STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-4021
Practice Address - Country:US
Practice Address - Phone:864-520-8910
Practice Address - Fax:864-520-8912
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2390224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant