Provider Demographics
NPI:1982121034
Name:GAFFNEY, MINDY (OT)
Entity Type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:
Last Name:GAFFNEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:STURGEON-LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1449 KIMBER LN STE 103A
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4067
Mailing Address - Country:US
Mailing Address - Phone:812-401-5210
Mailing Address - Fax:812-401-5220
Practice Address - Street 1:1449 KIMBER LN STE 103A
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4067
Practice Address - Country:US
Practice Address - Phone:812-401-5210
Practice Address - Fax:812-401-5220
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002266A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist