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General NPI Number Information
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NPI Number | 1518128404
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Entity Type | Individual
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Provider Name | LINDSAY JORDAN ELSTON OTR/L, CLT
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Gender | Female
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 1901 KNOX MCRAE DR
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City | TITUSVILLE
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State | FL
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Zip | 32780-5359
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Country | US
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Telephone | 321-268-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 SPRING CIR
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City | COCOA
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State | FL
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Zip | 32926-6418
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Country | US
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Telephone | 321-639-2084
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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 | OT12197
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License Number State | FL
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