Provider Demographics
NPI:1295958304
Name:BERTHIAUME, LYNDSI JUNE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:LYNDSI
Middle Name:JUNE
Last Name:BERTHIAUME
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 FISHER ST
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3369
Mailing Address - Country:US
Mailing Address - Phone:413-636-1934
Mailing Address - Fax:
Practice Address - Street 1:160 FISHER ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3369
Practice Address - Country:US
Practice Address - Phone:413-636-1934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9273225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist