Provider Demographics
NPI:1780454520
Name:DAVIS, LYNSEY LORAINE (OTD, OTR)
Entity type:Individual
Prefix:DR
First Name:LYNSEY
Middle Name:LORAINE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:LYNSEY
Other - Middle Name:LORAINE
Other - Last Name:STRESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6418 FISHER RD APT 107
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-1612
Mailing Address - Country:US
Mailing Address - Phone:214-707-8584
Mailing Address - Fax:
Practice Address - Street 1:1112 E COPELAND RD STE 300
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4910
Practice Address - Country:US
Practice Address - Phone:817-505-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123784225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist