Provider Demographics
NPI:1295925790
Name:LOCKHART, YVONNE LYNN (COTA)
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:LYNN
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1211
Mailing Address - Country:US
Mailing Address - Phone:732-423-3545
Mailing Address - Fax:732-251-1122
Practice Address - Street 1:6889ROUTE18 SOUTH
Practice Address - Street 2:
Practice Address - City:OLDBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857
Practice Address - Country:US
Practice Address - Phone:732-360-2277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TA09034100224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant