Healthcare Provider Details

I. General information

NPI: 1639768955
Provider Name (Legal Business Name): LINDSAY JOY OLREE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16455 E AVENUE OF THE FOUNTAINS
FOUNTAIN HILLS AZ
85268-8307
US

IV. Provider business mailing address

6980 E SAHUARO DR APT 1024
SCOTTSDALE AZ
85254-5293
US

V. Phone/Fax

Practice location:
  • Phone: 480-770-6990
  • Fax:
Mailing address:
  • Phone: 616-389-3287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number046861
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: