Provider Demographics
NPI:1518128404
Name:ELSTON, LINDSAY JORDAN (OTR/L, CLT)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:JORDAN
Last Name:ELSTON
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 SPRING CIR
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32926-6418
Mailing Address - Country:US
Mailing Address - Phone:321-639-2084
Mailing Address - Fax:
Practice Address - Street 1:1901 KNOX MCRAE DR
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-5359
Practice Address - Country:US
Practice Address - Phone:321-268-9399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12197225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist