Healthcare Provider Details

I. General information

NPI: 1932619780
Provider Name (Legal Business Name): LYNDSEY W BAXLEY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 10/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CENTURY PARK SOUTH SUITE 128
BIRMINGHAM AL
35226
US

IV. Provider business mailing address

PO BOX 360884
BIRMINGHAM AL
35236
US

V. Phone/Fax

Practice location:
  • Phone: 205-823-1215
  • Fax: 205-822-4999
Mailing address:
  • Phone: 205-823-1215
  • Fax: 205-822-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3739
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: