Provider Demographics
NPI:1417161241
Name:FRAZIER, LORRIE ANN (OTR)
Entity Type:Individual
Prefix:
First Name:LORRIE
Middle Name:ANN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LORRIE
Other - Middle Name:ANN
Other - Last Name:HOWARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:848 PARKERS LEVEE RD
Mailing Address - Street 2:
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-5585
Mailing Address - Country:US
Mailing Address - Phone:731-588-0621
Mailing Address - Fax:
Practice Address - Street 1:640 HANNINGS LN
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-3308
Practice Address - Country:US
Practice Address - Phone:731-587-3193
Practice Address - Fax:731-588-2732
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000690225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist