Provider Demographics
NPI:1366840555
Name:LAZOR, CATHERINE (OTA/L)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:LAZOR
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 ASPEN DR NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-1182
Mailing Address - Country:US
Mailing Address - Phone:330-550-9593
Mailing Address - Fax:
Practice Address - Street 1:179 ASPEN DR NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1182
Practice Address - Country:US
Practice Address - Phone:330-550-9593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-20
Last Update Date:2014-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOHOTA00148224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant