Provider Demographics
NPI:1851748198
Name:HANCOCK, LYNNE A (OT)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:A
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:A
Other - Last Name:CLARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:315 W MCLAIN DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-2605
Mailing Address - Country:US
Mailing Address - Phone:903-957-4810
Mailing Address - Fax:903-957-3415
Practice Address - Street 1:315 W MCLAIN DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-2605
Practice Address - Country:US
Practice Address - Phone:903-957-4810
Practice Address - Fax:903-957-3415
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117447225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist