Provider Demographics
NPI:1801518428
Name:TRAVIS, LINDSAY MCKOWEN (OT)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MCKOWEN
Last Name:TRAVIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MICHELLE
Other - Last Name:MCKOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:4324 S SHERWOOD FOREST BLVD STE B170
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4481
Mailing Address - Country:US
Mailing Address - Phone:225-654-8208
Mailing Address - Fax:225-465-8823
Practice Address - Street 1:1326 CHURCH ST
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2743
Practice Address - Country:US
Practice Address - Phone:225-654-8208
Practice Address - Fax:225-654-4642
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA330376225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist