Provider Demographics
NPI:1528217270
Name:PARADISE, LINDSEY ELLEN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:ELLEN
Last Name:PARADISE
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 1:215 WILTON CIR
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-9474
Mailing Address - Country:US
Mailing Address - Phone:270-871-8010
Mailing Address - Fax:
Practice Address - Street 1:2607 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025
Practice Address - Country:US
Practice Address - Phone:270-527-0147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR3998225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist