Healthcare Provider Details

I. General information

NPI: 1659447910
Provider Name (Legal Business Name): LOREYN LEIGH HANSEN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 CLINTON AVE S ABVI- GOODWILL
ROCHESTER NY
14620-1103
US

IV. Provider business mailing address

645 YALE STATION RD
GENEVA NY
14456-9249
US

V. Phone/Fax

Practice location:
  • Phone: 585-327-5598
  • Fax: 585-232-2972
Mailing address:
  • Phone: 315-585-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number015313-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number051313-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number015313-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number015313-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number015313-1
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT1085
License Number StateAK
# 7
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number015313-1
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code225XR0403X
TaxonomyDriving and Community Mobility Occupational Therapist
License Number015313-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: