Provider Demographics
NPI:1871742908
Name:CRUSE, LYNNE MARIE (CTRS)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:MARIE
Last Name:CRUSE
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11786 WESTLINE INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-3402
Mailing Address - Country:US
Mailing Address - Phone:314-983-9230
Mailing Address - Fax:314-983-9235
Practice Address - Street 1:11786 WESTLINE INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3402
Practice Address - Country:US
Practice Address - Phone:314-983-9230
Practice Address - Fax:314-983-9235
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist