Healthcare Provider Details

I. General information

NPI: 1780514521
Provider Name (Legal Business Name): LORRIE CARR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 W DAYTON ST
MADISON WI
53703-1967
US

IV. Provider business mailing address

3632 MATHIAS WAY
VERONA WI
53593-9587
US

V. Phone/Fax

Practice location:
  • Phone: 608-663-1879
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2774-26
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: