Provider Demographics
NPI:1326272527
Name:KOORY, JANICE LYNN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:LYNN
Last Name:KOORY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 S 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1965
Mailing Address - Country:US
Mailing Address - Phone:402-926-4088
Mailing Address - Fax:402-926-4197
Practice Address - Street 1:4905 S 107TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1965
Practice Address - Country:US
Practice Address - Phone:402-926-4088
Practice Address - Fax:402-926-4197
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE296225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist