Provider Demographics
NPI:1497521066
Name:OSTLIEN, MAKALEY LYN (OTR/L)
Entity Type:Individual
Prefix:
First Name:MAKALEY
Middle Name:LYN
Last Name:OSTLIEN
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 1:5927 PRUE RD UNIT 602
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3389
Mailing Address - Country:US
Mailing Address - Phone:325-665-1841
Mailing Address - Fax:
Practice Address - Street 1:5927 PRUE RD UNIT 602
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3389
Practice Address - Country:US
Practice Address - Phone:325-665-1841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124245225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist