Provider Demographics
NPI:1851801278
Name:CARPENTER, LINDSAY KATE (LOTR)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:KATE
Last Name:CARPENTER
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5595 HIGHWAY 481
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:LA
Mailing Address - Zip Code:71419-3315
Mailing Address - Country:US
Mailing Address - Phone:318-510-2999
Mailing Address - Fax:
Practice Address - Street 1:8730 YOUREE DR STE B
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2518
Practice Address - Country:US
Practice Address - Phone:318-227-9002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA307065225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist