Provider Demographics
NPI:1144791823
Name:HOEZEE, LORI JEAN (OTR)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:JEAN
Last Name:HOEZEE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3382 GASLIGHT LN
Mailing Address - Street 2:
Mailing Address - City:SAUGATUCK
Mailing Address - State:MI
Mailing Address - Zip Code:49453-9497
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3382 GASLIGHT LN
Practice Address - Street 2:
Practice Address - City:SAUGATUCK
Practice Address - State:MI
Practice Address - Zip Code:49453-9497
Practice Address - Country:US
Practice Address - Phone:616-617-1677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009639225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist