Provider Demographics
NPI:1346418399
Name:MAYNARD, LYNN MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:MAYNARD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:MARIE
Other - Last Name:CREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:50 STETSON ST
Mailing Address - Street 2:
Mailing Address - City:WHITMAN
Mailing Address - State:MA
Mailing Address - Zip Code:02382-2440
Mailing Address - Country:US
Mailing Address - Phone:781-447-0414
Mailing Address - Fax:
Practice Address - Street 1:50 STETSON ST
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-2440
Practice Address - Country:US
Practice Address - Phone:781-447-0414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1979225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist