Provider Demographics
NPI:1225406408
Name:GATTON, LINDSEY (COTA/L)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GATTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HARPER
Mailing Address - State:IA
Mailing Address - Zip Code:52231
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARPER
Practice Address - State:IA
Practice Address - Zip Code:52231-8815
Practice Address - Country:US
Practice Address - Phone:319-430-7428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000988172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker