Provider Demographics
NPI:1295145332
Name:DELINDE, LAURIE G (OT)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:G
Last Name:DELINDE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:L
Other - Last Name:GRISBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 826366
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-6366
Mailing Address - Country:US
Mailing Address - Phone:302-302-6915
Mailing Address - Fax:302-691-5168
Practice Address - Street 1:701 FOULK RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3733
Practice Address - Country:US
Practice Address - Phone:302-691-5167
Practice Address - Fax:302-691-5168
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU10001443225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist