Provider Demographics
NPI:1467767392
Name:GIANGARRA, LORI ELLEN (OT)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ELLEN
Last Name:GIANGARRA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 MONTEREY ST
Mailing Address - Street 2:
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32927-8459
Mailing Address - Country:US
Mailing Address - Phone:321-759-9941
Mailing Address - Fax:
Practice Address - Street 1:3955 MONTEREY ST
Practice Address - Street 2:
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32927-8459
Practice Address - Country:US
Practice Address - Phone:321-759-9941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11999225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist