Provider Demographics
NPI:1508234931
Name:BRUNETTE, LINDSEY (OTR)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:BRUNETTE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:70 POST OFFICE PARK
Practice Address - Street 2:SUITE 7007
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1290
Practice Address - Country:US
Practice Address - Phone:413-279-1435
Practice Address - Fax:413-279-1438
Is Sole Proprietor?:No
Enumeration Date:2015-09-02
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11609225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist