Provider Demographics
NPI:1932395217
Name:DIETRICH, LYNN A (OT)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:A
Last Name:DIETRICH
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 THOMPSON RUN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3371
Mailing Address - Country:US
Mailing Address - Phone:412-487-1948
Mailing Address - Fax:
Practice Address - Street 1:306 THOMPSON RUN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-3371
Practice Address - Country:US
Practice Address - Phone:412-487-1948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005476L225X00000X
DEU1-0001365225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist