Provider Demographics
NPI:1811300858
Name:VERKAMP, LINDSAY (COTA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:VERKAMP
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:BARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:9 ROLLING RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-9098
Mailing Address - Country:US
Mailing Address - Phone:812-639-0761
Mailing Address - Fax:
Practice Address - Street 1:9 ROLLING RIDGE CT
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-9098
Practice Address - Country:US
Practice Address - Phone:812-639-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-07
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32002621A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant