Provider Demographics
NPI:1790178168
Name:MACVICAR, LINDSEY (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:
Last Name:MACVICAR
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 BUBAR RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:ME
Mailing Address - Zip Code:04971-7030
Mailing Address - Country:US
Mailing Address - Phone:207-416-9982
Mailing Address - Fax:
Practice Address - Street 1:74 PARKWAY S
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1628
Practice Address - Country:US
Practice Address - Phone:207-989-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2960225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist