Provider Demographics
NPI:1659565364
Name:JENKINS, LYNN (COTA/L)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LYNN
Other - Last Name:BRINKLEY-RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:14014 CROSSING WAY E
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4730
Mailing Address - Country:US
Mailing Address - Phone:405-205-0881
Mailing Address - Fax:
Practice Address - Street 1:14014 CROSSING WAY E
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4730
Practice Address - Country:US
Practice Address - Phone:405-205-0881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0A199171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor