Provider Demographics
NPI:1053714220
Name:FLICKER, LINDSEY JEAN (OTR)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JEAN
Last Name:FLICKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:JEAN
Other - Last Name:WOLSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:801 BROADWAY N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58122-3641
Mailing Address - Country:US
Mailing Address - Phone:701-234-7115
Mailing Address - Fax:
Practice Address - Street 1:801 BROADWAY N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-3641
Practice Address - Country:US
Practice Address - Phone:701-234-5608
Practice Address - Fax:701-234-7451
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist