Provider Demographics
NPI:1679908453
Name:LINDSAY, GLORIA NOEL (OTR/L)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:NOEL
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 1:11261 EXETER ST
Mailing Address - Street 2:APT C
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3050
Mailing Address - Country:US
Mailing Address - Phone:909-894-9930
Mailing Address - Fax:
Practice Address - Street 1:11261 EXETER ST
Practice Address - Street 2:APT C
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3050
Practice Address - Country:US
Practice Address - Phone:909-894-9930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 11618225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist