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General NPI Number Information
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NPI Number | 1295859007
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Entity Type | Individual
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Provider Name | AMY DIMARCO LOTR
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 04/16/2018
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Provider Practice Location Address
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Address Line | 719 SEVERN AVE
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City | METAIRIE
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State | LA
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Zip | 70001-5150
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Country | US
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Telephone | 504-430-9218
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Fax |
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Provider Business Mailing Address
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Address Line | 719 SEVERN AVE
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City | METAIRIE
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State | LA
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Zip | 70001-5150
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Country | US
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Telephone | 504-430-9218
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | OTT.Z11994
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OTT.Z11994
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License Number State | LA
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