Provider Demographics
NPI:1912467804
Name:ALIAH, LYNDSEY
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:ALIAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25437 BIRCHWOODS DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-2113
Mailing Address - Country:US
Mailing Address - Phone:517-375-1380
Mailing Address - Fax:
Practice Address - Street 1:25437 BIRCHWOODS DR
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-2113
Practice Address - Country:US
Practice Address - Phone:517-375-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005813225X00000X
WAOT60783695225X00000X
VA0119008023225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist