MEDICARE: LYNDSEY MUELLER

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	225XP0200X	Pediatric Occupational Therapist	2006024004	MO

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	:	1619011293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNDSEY MUELLER

Provider Business Mailing Address
First Line	:	7532 TERRI LYNN DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-1666
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12430 TESSON FERRY RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63128-2702
Country	:	US
Telephone Number	:	314-495-5437
Fax Number	:

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

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	07/08/2007

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Directions to “ LYNDSEY MUELLER ” Practice Location

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