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General NPI Number Information
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NPI Number | 1679967194
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Entity Type | Individual
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Provider Name | LAUREN LOTZ MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 529 WESTPORT RD
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City | ELIZABETHTOWN
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State | KY
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Zip | 42701-2949
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Country | US
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Telephone | 270-763-8225
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Fax |
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Provider Business Mailing Address
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Address Line | 328 MONOHAN DR
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City | LOUISVILLE
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State | KY
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Zip | 40207-4032
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Country | US
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Telephone |
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | R5787
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License Number State | KY
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