Healthcare Provider Details

I. General information

NPI: 1932409463
Provider Name (Legal Business Name): KATE ORVOLD LOTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 SAINT CLAUDE AVE
NEW ORLEANS LA
70117-6144
US

IV. Provider business mailing address

3419 SAINT CLAUDE AVE
NEW ORLEANS LA
70117-6144
US

V. Phone/Fax

Practice location:
  • Phone: 504-942-2805
  • Fax: 504-942-2805
Mailing address:
  • Phone: 504-942-2805
  • Fax: 504-942-2805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOTT.200323
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: