Provider Demographics
NPI:1003395476
Name:MOWERY, LORI (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:MOWERY
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 WILDFLOWER LN NE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-4900
Mailing Address - Country:US
Mailing Address - Phone:330-412-1573
Mailing Address - Fax:
Practice Address - Street 1:1128 WATERLOO RD
Practice Address - Street 2:
Practice Address - City:MOGADORE
Practice Address - State:OH
Practice Address - Zip Code:44260-9577
Practice Address - Country:US
Practice Address - Phone:330-628-3430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.06430224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant