Provider Demographics
NPI:1023307535
Name:LINCOLN, LEE ANN (COTA/L)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:ANN
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14548 BAYMAN ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH LAWRENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44666-9705
Mailing Address - Country:US
Mailing Address - Phone:330-428-4122
Mailing Address - Fax:
Practice Address - Street 1:14548 BAYMAN ST NW
Practice Address - Street 2:
Practice Address - City:NORTH LAWRENCE
Practice Address - State:OH
Practice Address - Zip Code:44666-9705
Practice Address - Country:US
Practice Address - Phone:330-428-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA3109224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant