Provider Demographics
NPI:1518036839
Name:LINDLEY KESSLER, FARRELL S (OT)
Entity Type:Individual
Prefix:
First Name:FARRELL
Middle Name:S
Last Name:LINDLEY KESSLER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 W HEATHER PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-1428
Mailing Address - Country:US
Mailing Address - Phone:208-631-7366
Mailing Address - Fax:208-631-7366
Practice Address - Street 1:2811 W HEATHER PL
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-1428
Practice Address - Country:US
Practice Address - Phone:208-631-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT-653225X00000X
IDOT653225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist