Provider Demographics
NPI:1679721674
Name:LIENECK, JANE LINDSEY (OTR)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:LINDSEY
Last Name:LIENECK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:LINDSEY
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7900 WISTERIA VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-1994
Mailing Address - Country:US
Mailing Address - Phone:512-940-5064
Mailing Address - Fax:512-870-9374
Practice Address - Street 1:7900 WISTERIA VALLEY DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78739-1994
Practice Address - Country:US
Practice Address - Phone:512-940-5064
Practice Address - Fax:512-870-9374
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111103OtherOTR STATE LICENSE