Provider Demographics
NPI:1750777017
Name:GOUDE, LINDSAY CHRISTINE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:CHRISTINE
Last Name:GOUDE
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 TRUMPET ST SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-3417
Mailing Address - Country:US
Mailing Address - Phone:731-307-0303
Mailing Address - Fax:
Practice Address - Street 1:508 TRUMPET ST SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-3417
Practice Address - Country:US
Practice Address - Phone:731-307-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA12896224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant