Provider Demographics
NPI:1184410656
Name:KOZLOWSKI, LINDSEY RAE (OTR/L)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RAE
Last Name:KOZLOWSKI
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:RAE
Other - Middle Name:
Other - Last Name:KOZLOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5151 E ROCK LEDGE LN
Mailing Address - Street 2:
Mailing Address - City:KANAB
Mailing Address - State:UT
Mailing Address - Zip Code:84741-4113
Mailing Address - Country:US
Mailing Address - Phone:301-712-8700
Mailing Address - Fax:
Practice Address - Street 1:1801 N NAVAJO DR
Practice Address - Street 2:
Practice Address - City:PAGE
Practice Address - State:AZ
Practice Address - Zip Code:86040-0980
Practice Address - Country:US
Practice Address - Phone:301-712-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-009971225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist