Provider Demographics
NPI:1174005771
Name:UNGER, LORENA MICHELLE (COTA)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:MICHELLE
Last Name:UNGER
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 E SAM HOUSTON PKWY S
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-1400
Mailing Address - Country:US
Mailing Address - Phone:281-998-0399
Mailing Address - Fax:
Practice Address - Street 1:4900 E SAM HOUSTON PKWY S
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-1400
Practice Address - Country:US
Practice Address - Phone:281-998-0399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208326224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant