Healthcare Provider Details

I. General information

NPI: 1609784396
Provider Name (Legal Business Name): KAYLIE LINGL OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4695 E NORTHFIELD DR
BROWNSBURG IN
46112-1784
US

IV. Provider business mailing address

8737 LAKE HILLS DR
SAINT JOHN IN
46373-8730
US

V. Phone/Fax

Practice location:
  • Phone: 317-520-4748
  • Fax: 888-498-5529
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31009162A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: