Provider Demographics
NPI:1245033620
Name:EDWARDS, LINDSAY MICHELLE (OT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MICHELLE
Last Name:EDWARDS
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 E US HIGHWAY 80 STE G
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:GA
Mailing Address - Zip Code:31302-8914
Mailing Address - Country:US
Mailing Address - Phone:912-420-4910
Mailing Address - Fax:912-600-1994
Practice Address - Street 1:106 E US HIGHWAY 80 STE G
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:GA
Practice Address - Zip Code:31302-8914
Practice Address - Country:US
Practice Address - Phone:912-420-4910
Practice Address - Fax:912-600-1994
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT009461225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist