Individual
MS. LYNDA MARIE FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
516 176TH ST E, SPANAWAY, WA 98387-8335
(253) 683-5856
Mailing address
516 176TH ST E, SPANAWAY, WA 98387-8335
(253) 683-5856
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT00001047
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
296977B
ESA CERTIFICATION
WA
01
—
OT00001047
DEPARTMENT OF HEALTH OCCUPATIONAL THERAPY LICENSE
WA
Enumeration date
10/30/2012
Last updated
10/30/2012
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