Provider Demographics
NPI:1275301764
Name:SPELL, LINDSAY ALEXANDRA (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:ALEXANDRA
Last Name:SPELL
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4480 CLAYTON AVE # 85054501
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1624
Mailing Address - Country:US
Mailing Address - Phone:314-273-5442
Mailing Address - Fax:
Practice Address - Street 1:4480 CLAYTON AVE # 85054501
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1624
Practice Address - Country:US
Practice Address - Phone:314-273-5442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-14
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO171W00000X
MO2023044218225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No171W00000XOther Service ProvidersContractor