Provider Demographics
NPI:1083791040
Name:LAHR, ALICIA D (MS OTRL)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:D
Last Name:LAHR
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:MARRONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTRL
Mailing Address - Street 1:1511 CENTRE TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961
Mailing Address - Country:US
Mailing Address - Phone:570-366-3722
Mailing Address - Fax:570-366-3781
Practice Address - Street 1:1511 CENTRE TURNPIKE
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961
Practice Address - Country:US
Practice Address - Phone:570-366-3722
Practice Address - Fax:570-366-3781
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC006874L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50009415OtherBLUE CROSS
PA0019288560002Medicaid