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General NPI Number Information
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NPI Number | 1336627991
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Entity Type | Individual
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Provider Name | LINDSEY N GREENE DOT
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Gender | Female
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Dates
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Enumeration Date | 08/04/2018
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Last Update Date | 04/12/2022
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Provider Practice Location Address
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Address Line | 11246 SW OLMSTEAD DR
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-1945
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Country | US
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Telephone | 954-579-5619
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Fax |
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Provider Business Mailing Address
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Address Line | 11246 SW OLMSTEAD DRIVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987-1945
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Country | US
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Telephone | 954-579-5619
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Fax | 772-673-0523
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 136528
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT21809
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License Number State | FL
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