Provider Demographics
NPI:1952640534
Name:KISSINGER, LINDSEY JO (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:JO
Last Name:KISSINGER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 EISENHAUER RD
Mailing Address - Street 2:
Mailing Address - City:COAL TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:17866-7723
Mailing Address - Country:US
Mailing Address - Phone:570-238-0761
Mailing Address - Fax:
Practice Address - Street 1:124 EISENHAUER RD
Practice Address - Street 2:
Practice Address - City:COAL TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:17866-7723
Practice Address - Country:US
Practice Address - Phone:570-238-0761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP006512224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant