Provider Demographics
NPI:1346887486
Name:LEVY, LORI ANN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:LEVY
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 1:455 COUNTRY RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8522
Mailing Address - Country:US
Mailing Address - Phone:631-379-4948
Mailing Address - Fax:
Practice Address - Street 1:1370 BRASS MILL RD
Practice Address - Street 2:
Practice Address - City:BELCAMP
Practice Address - State:MD
Practice Address - Zip Code:21017-1211
Practice Address - Country:US
Practice Address - Phone:410-688-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06277225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics