Provider Demographics
NPI:1437911377
Name:MEREDITH, LINDSEY NICOLA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:NICOLA
Last Name:MEREDITH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:NICOLA
Other - Last Name:KEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:841 COUNTY ROAD 480
Mailing Address - Street 2:
Mailing Address - City:KIRBYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75956-4355
Mailing Address - Country:US
Mailing Address - Phone:409-423-0212
Mailing Address - Fax:
Practice Address - Street 1:920 E AVENUE L
Practice Address - Street 2:
Practice Address - City:SILSBEE
Practice Address - State:TX
Practice Address - Zip Code:77656-5014
Practice Address - Country:US
Practice Address - Phone:409-385-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217642224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant