Provider Demographics
NPI:1801184825
Name:BEARDEN, LYNN (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:BEARDEN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11345 EXMOOR DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:44077-2300
Mailing Address - Country:US
Mailing Address - Phone:216-440-1056
Mailing Address - Fax:
Practice Address - Street 1:903 LAKE LILY DR APT B402
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7653
Practice Address - Country:US
Practice Address - Phone:216-440-1056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist