Provider Demographics
NPI:1174845473
Name:LORIE, CASSANDRA BLAIR (OTR)
Entity Type:Individual
Prefix:MS
First Name:CASSANDRA
Middle Name:BLAIR
Last Name:LORIE
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 1:2232 PURDUE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-1412
Mailing Address - Country:US
Mailing Address - Phone:410-746-1482
Mailing Address - Fax:
Practice Address - Street 1:5300 W 29TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-8399
Practice Address - Country:US
Practice Address - Phone:970-353-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-27
Last Update Date:2010-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1832225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist