Healthcare Provider Details

I. General information

NPI: 1366956070
Provider Name (Legal Business Name): ABBY LYNN EDIE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABBY LYNN FROMAN

II. Dates (important events)

Enumeration Date: 11/17/2017
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8884 DANIEL LN NW
STRASBURG OH
44680-9700
US

IV. Provider business mailing address

103 PLANTATION CIR
BEAUFORT NC
28516-1757
US

V. Phone/Fax

Practice location:
  • Phone: 330-268-4316
  • Fax:
Mailing address:
  • Phone: 330-878-7681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number11102
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT010679
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: