Provider Demographics
NPI:1952537250
Name:RUPNOW, LYNDSAY (COTA)
Entity type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:
Last Name:RUPNOW
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N9416 COUNTY ROAD U
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53508-9405
Mailing Address - Country:US
Mailing Address - Phone:608-843-2186
Mailing Address - Fax:
Practice Address - Street 1:100 S 1ST ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOREB
Practice Address - State:WI
Practice Address - Zip Code:53572-1906
Practice Address - Country:US
Practice Address - Phone:608-437-5515
Practice Address - Fax:608-437-5514
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2052-27224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant