Healthcare Provider Details

I. General information

NPI: 1225731847
Provider Name (Legal Business Name): LORRIN CHRISTENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2023
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5733 PORANO CIR
ROUND ROCK TX
78665-2104
US

IV. Provider business mailing address

5733 PORANO CIR
ROUND ROCK TX
78665-2104
US

V. Phone/Fax

Practice location:
  • Phone: 573-213-0816
  • Fax:
Mailing address:
  • Phone: 573-213-0816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number215007
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: