Provider Demographics
NPI:1437341781
Name:FALICK, LYNNE S (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:S
Last Name:FALICK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7647 S WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3013
Mailing Address - Country:US
Mailing Address - Phone:303-794-9297
Mailing Address - Fax:303-794-3255
Practice Address - Street 1:7647 S WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80122-3013
Practice Address - Country:US
Practice Address - Phone:303-794-9297
Practice Address - Fax:303-794-3255
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO084356225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO084356OtherNATIONAL CERTIFICATION