Provider Demographics
NPI:1508501750
Name:FLORES, LINDSAY ALYSSA (OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ALYSSA
Last Name:FLORES
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 1:340 W 25TH ST APT 1225
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-2892
Mailing Address - Country:US
Mailing Address - Phone:862-368-0317
Mailing Address - Fax:
Practice Address - Street 1:6034 HEATH VALLEY RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-4352
Practice Address - Country:US
Practice Address - Phone:704-577-9937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13342225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty