Provider Demographics
NPI:1265851349
Name:BOMBELYN, LINDSEY ROBERTS (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:ROBERTS
Last Name:BOMBELYN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:LINDSEY
Other - Middle Name:ROBERTS
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:456 MENCHVILLE RD S
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-7509
Mailing Address - Country:US
Mailing Address - Phone:757-812-5184
Mailing Address - Fax:
Practice Address - Street 1:456 MENCHVILLE RD S
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-7509
Practice Address - Country:US
Practice Address - Phone:757-812-5184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004779225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist