Provider Demographics
NPI:1649532474
Name:SNOW, LINDSEY DALE (MOT, OTR, ATC, LAT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:DALE
Last Name:SNOW
Suffix:
Gender:F
Credentials:MOT, OTR, ATC, LAT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:DALE
Other - Last Name:MIHOLOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAIDEN
Mailing Address - Street 1:PO BOX 932184
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-2184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2241 PEGGY LN STE C
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5709
Practice Address - Country:US
Practice Address - Phone:972-272-9643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114694225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist