Provider Demographics
NPI:1679782296
Name:BURNS, LYNN DOROTHY (OTR)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:DOROTHY
Last Name:BURNS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BARTRAM TRAIL
Mailing Address - Street 2:
Mailing Address - City:CENTRAL
Mailing Address - State:SC
Mailing Address - Zip Code:29630
Mailing Address - Country:US
Mailing Address - Phone:505-270-1977
Mailing Address - Fax:505-823-8379
Practice Address - Street 1:6301 FOREST HILLS DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4137
Practice Address - Country:US
Practice Address - Phone:505-823-8338
Practice Address - Fax:505-823-8379
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM229225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist