Healthcare Provider Details

I. General information

NPI: 1144542473
Provider Name (Legal Business Name): SARAH ANNE LORENZEN MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 RESEARCH PKWY STE 255
COLORADO SPRINGS CO
80920-1097
US

IV. Provider business mailing address

4113 BENT DR
COLORADO SPRINGS CO
80909-5404
US

V. Phone/Fax

Practice location:
  • Phone: 719-260-8400
  • Fax: 719-260-8405
Mailing address:
  • Phone: 719-822-3345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT13999
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: