Provider Demographics
NPI:1477253961
Name:SHEPHERD, LYNDSAY N (OTD, OTR)
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:N
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:LYNDSAY
Other - Middle Name:N
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1850 S PRIVATE ROAD 310 W
Mailing Address - Street 2:
Mailing Address - City:NORTH VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47265-7081
Mailing Address - Country:US
Mailing Address - Phone:812-525-5087
Mailing Address - Fax:
Practice Address - Street 1:1176 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-1251
Practice Address - Country:US
Practice Address - Phone:812-343-2797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31007787A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist