Provider Demographics
NPI:1790414928
Name:LOPER, LINDIE (MOTR/L)
Entity Type:Individual
Prefix:MISS
First Name:LINDIE
Middle Name:
Last Name:LOPER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:LINDIE
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:506 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2744
Mailing Address - Country:US
Mailing Address - Phone:662-416-0645
Mailing Address - Fax:
Practice Address - Street 1:1411 HIGHWAY 389
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-8451
Practice Address - Country:US
Practice Address - Phone:166-231-2838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-04
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3939225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics