MEDICARE: THERESA LYNCH MS, OTRL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	5201007131	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144503806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA LYNCH MS, OTRL

Provider Business Mailing Address
First Line	:	PO BOX 10262
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34101-0262
Country	:	US
Telephone Number	:	239-776-4001
Fax Number	:	239-494-4365

Provider Business Practice Location Address
First Line	:	1044 CASTELLO DR STE 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-8981
Country	:	US
Telephone Number	:	239-776-4001
Fax Number	:	239-494-4365

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2011
Last Update Date	:	03/30/2024

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