Provider Demographics
NPI:1437498243
Name:DOUGLAS, LINDSAY JOANN (COTA/L)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:JOANN
Last Name:DOUGLAS
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 1:890 SPRINGHILL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:GA
Mailing Address - Zip Code:30411-3720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:890 SPRINGHILL CHURCH RD
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:GA
Practice Address - Zip Code:30411-3720
Practice Address - Country:US
Practice Address - Phone:229-315-4403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOTA001420174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist