Provider Demographics
NPI:1689720773
Name:LYNCH, SHEILA KAY (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:KAY
Last Name:LYNCH
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4541 WERNER RD
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049-2888
Mailing Address - Country:US
Mailing Address - Phone:636-677-8215
Mailing Address - Fax:
Practice Address - Street 1:1500 S 5TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-4103
Practice Address - Country:US
Practice Address - Phone:636-896-0999
Practice Address - Fax:636-896-0998
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001016608225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist