Provider Demographics
NPI:1750689568
Name:BURKHART, LINDSAY KAY (COTA/L)
Entity Type:Individual
Prefix:MISS
First Name:LINDSAY
Middle Name:KAY
Last Name:BURKHART
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:READING STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19606-1912
Mailing Address - Country:US
Mailing Address - Phone:610-223-4063
Mailing Address - Fax:
Practice Address - Street 1:500 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-2764
Practice Address - Country:US
Practice Address - Phone:610-777-7841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006961224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant