Provider Demographics
NPI:1245436062
Name:O'BRIEN, LYNETTE MARIE (OTRL)
Entity type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:MARIE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 TYLER CT
Mailing Address - Street 2:
Mailing Address - City:COTTONTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37048-9666
Mailing Address - Country:US
Mailing Address - Phone:615-775-1893
Mailing Address - Fax:
Practice Address - Street 1:1215 21ST AVE S
Practice Address - Street 2:MCE SOUTH TOWER SUITE 3312
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0014
Practice Address - Country:US
Practice Address - Phone:615-343-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002401225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist