Provider Demographics
NPI:1598222747
Name:LINDSAY, TAYLOR RAE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:RAE
Last Name:LINDSAY
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 1:1110 CROOKED CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-6100
Mailing Address - Country:US
Mailing Address - Phone:404-274-6415
Mailing Address - Fax:
Practice Address - Street 1:1270 MCCONNELL DR STE B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3507
Practice Address - Country:US
Practice Address - Phone:404-274-6415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007289225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist