Provider Demographics
NPI:1407190424
Name:LYNCH, KATHERINE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9727 TOUCHTON RD
Mailing Address - Street 2:APT 1405
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-8229
Mailing Address - Country:US
Mailing Address - Phone:904-346-5100
Mailing Address - Fax:
Practice Address - Street 1:4600 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-4764
Practice Address - Country:US
Practice Address - Phone:904-346-5100
Practice Address - Fax:904-346-5100
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4038225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist