Provider Demographics
NPI:1437827698
Name:BUGG, LINDSEY NOELLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:NOELLE
Last Name:BUGG
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 1:42 NORTH PL
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6200
Mailing Address - Country:US
Mailing Address - Phone:443-370-1746
Mailing Address - Fax:
Practice Address - Street 1:5104 PEGASUS CT STE B
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-8323
Practice Address - Country:US
Practice Address - Phone:443-776-0271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist