Provider Demographics
NPI:1689437444
Name:DIAB, LINDSAY (OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:DIAB
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 1:5607 OLD GARDEN RD APT 301
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4186
Mailing Address - Country:US
Mailing Address - Phone:910-742-2677
Mailing Address - Fax:
Practice Address - Street 1:4302 HOLLY TREE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6838
Practice Address - Country:US
Practice Address - Phone:910-343-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16575225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist