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General NPI Number Information
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NPI Number | 1356511018
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Entity Type | Individual
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Provider Name | PAULA JEAN LYNN MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/08/2008
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Last Update Date | 03/11/2024
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Provider Practice Location Address
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Address Line | 3117 SHORE DR STE 101
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City | MARINETTE
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State | WI
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Zip | 54143-4293
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Country | US
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Telephone | 715-735-4200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735031
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City | CHICAGO
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State | IL
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Zip | 60673-5031
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Country | US
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Telephone | 800-326-2250
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Fax |
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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 | 4562-026
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License Number State | WI
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