Provider Demographics
NPI:1760452262
Name:LAWLER, TINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:LAWLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:DENEKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:749 17TH ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-2420
Mailing Address - Country:US
Mailing Address - Phone:515-382-2045
Mailing Address - Fax:
Practice Address - Street 1:1215 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5400
Practice Address - Country:US
Practice Address - Phone:515-956-4095
Practice Address - Fax:515-956-4093
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01223225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist