Provider Demographics
NPI:1780857201
Name:HERNER, LINDA L (OT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:HERNER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:L
Other - Last Name:RINGENBERGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:177 BRIDGEMOR LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-7303
Mailing Address - Country:US
Mailing Address - Phone:317-965-8675
Mailing Address - Fax:
Practice Address - Street 1:7855 S EMERSON AVE STE H
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-8669
Practice Address - Country:US
Practice Address - Phone:317-300-0370
Practice Address - Fax:317-300-0422
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000102A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist