Provider Demographics
NPI:1356104079
Name:MEYER, LINDSAY DYAN (OTA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:DYAN
Last Name:MEYER
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:DYAN
Other - Last Name:SCHUCHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26330 MARQUETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:MO
Mailing Address - Zip Code:65236-2462
Mailing Address - Country:US
Mailing Address - Phone:660-631-9500
Mailing Address - Fax:
Practice Address - Street 1:26330 MARQUETTE AVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:MO
Practice Address - Zip Code:65236-2462
Practice Address - Country:US
Practice Address - Phone:660-631-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012001046224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant