Provider Demographics
NPI:1679590194
Name:VANSYCKLE, LINDA JANE
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JANE
Last Name:VANSYCKLE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:JANE
Other - Last Name:VANSYCKLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:5500 ARMSTRONG RD
Mailing Address - Street 2:OCCUPATIONAL THERAPY VAMC
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015
Mailing Address - Country:US
Mailing Address - Phone:269-966-5600
Mailing Address - Fax:269-966-5481
Practice Address - Street 1:5500 ARMSTRONG RD
Practice Address - Street 2:OCCUPATIONAL THERAPY VAMC
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015
Practice Address - Country:US
Practice Address - Phone:269-966-5600
Practice Address - Fax:269-966-5481
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201001384225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist