Provider Demographics
NPI:1720591381
Name:SANDERLIN, LINDSAY (MOT-OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:SANDERLIN
Suffix:
Gender:F
Credentials:MOT-OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5204
Mailing Address - Country:US
Mailing Address - Phone:318-338-2081
Mailing Address - Fax:
Practice Address - Street 1:3201 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5204
Practice Address - Country:US
Practice Address - Phone:318-338-2081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA307718225X00000X
LAOTA.20027224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant