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General NPI Number Information
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NPI Number | 1942997119
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Entity Type | Individual
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Provider Name | LYNSEY MCA'NULTY OTA
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Gender | Female
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 4 MILITIA DR STE 18
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City | LEXINGTON
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State | MA
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Zip | 02421-4714
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Country | US
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Telephone | 781-861-0695
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Fax | 781-861-0829
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Provider Business Mailing Address
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Address Line | 115 FLORAL AVE
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City | MALDEN
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State | MA
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Zip | 02148-1537
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Country | US
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Telephone | 978-420-9874
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 4856
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License Number State | MA
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