1467669630 NPI number — MRS. LAURIE ANN STOHR OTR

Table of content: MRS. LAURIE ANN STOHR OTR (NPI 1467669630)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467669630 NPI number — MRS. LAURIE ANN STOHR OTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STOHR
Provider First Name:
LAURIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467669630
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18435 COTTONWOOD CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENDALE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47025-8675
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-539-4948
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 WILSON CREEK RD
Provider Second Line Business Practice Location Address:
OCCUPATIONAL THERAPY
Provider Business Practice Location Address City Name:
LAWRENCEBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47025-2751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-532-2607
Provider Business Practice Location Address Fax Number:
812-537-3514
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X , with the licence number:  31003668A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com