Provider Demographics
NPI:1760412878
Name:KAISER, LYNN M (OT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:KAISER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14700 KING RD STE B
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:MI
Mailing Address - Zip Code:48193-7909
Mailing Address - Country:US
Mailing Address - Phone:734-288-0235
Mailing Address - Fax:734-288-0236
Practice Address - Street 1:14700 KING RD STE B
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:MI
Practice Address - Zip Code:48193-7909
Practice Address - Country:US
Practice Address - Phone:734-288-0235
Practice Address - Fax:734-288-0236
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist