Provider Demographics
NPI:1417459462
Name:CHRISTENSEN, LORI JEAN (OTR)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:JEAN
Last Name:CHRISTENSEN
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 1:2885 E FISHER RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3050
Mailing Address - Country:US
Mailing Address - Phone:989-245-5450
Mailing Address - Fax:
Practice Address - Street 1:3340 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-9622
Practice Address - Country:US
Practice Address - Phone:989-790-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002812225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist