Provider Demographics
NPI:1760921233
Name:IVEY, LINDSEY S (OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:S
Last Name:IVEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 E HEARNE WAY
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-6040
Mailing Address - Country:US
Mailing Address - Phone:505-264-6830
Mailing Address - Fax:
Practice Address - Street 1:815 E WARNER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1057
Practice Address - Country:US
Practice Address - Phone:480-963-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6902225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist