Provider Demographics
NPI:1902230758
Name:LINDSTROM, REBECCA THORNE (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:THORNE
Last Name:LINDSTROM
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 1:3408 E SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-2041
Mailing Address - Country:US
Mailing Address - Phone:602-996-7832
Mailing Address - Fax:
Practice Address - Street 1:1012 E WILLETTA ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2749
Practice Address - Country:US
Practice Address - Phone:602-839-4760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2121225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist