Provider Demographics
NPI:1255062295
Name:FARRELL, LYDIA ANNA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:ANNA
Last Name:FARRELL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LYDIA
Other - Middle Name:ANNA
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3200 WADEBRIDGE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-1899
Mailing Address - Country:US
Mailing Address - Phone:703-345-8088
Mailing Address - Fax:
Practice Address - Street 1:112 N CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-2792
Practice Address - Country:US
Practice Address - Phone:757-890-0675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist