Provider Demographics
NPI:1174880272
Name:KOLENY, LINDSAY MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:KOLENY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10870 BUTTERCUP PL
Mailing Address - Street 2:APT. 104
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-5638
Mailing Address - Country:US
Mailing Address - Phone:724-681-2904
Mailing Address - Fax:
Practice Address - Street 1:8605 CENTREVILLE RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5265
Practice Address - Country:US
Practice Address - Phone:703-257-6258
Practice Address - Fax:703-330-8874
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005614225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist