Provider Demographics
NPI:1508101908
Name:SALTZMAN, LORIE (OT)
Entity Type:Individual
Prefix:MRS
First Name:LORIE
Middle Name:
Last Name:SALTZMAN
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 1:39 SOVEREIGN LN
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-6200
Mailing Address - Country:US
Mailing Address - Phone:813-817-3445
Mailing Address - Fax:
Practice Address - Street 1:39 SOVEREIGN LN
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-6200
Practice Address - Country:US
Practice Address - Phone:813-817-3445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9419171W00000X
NCOT8720225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No171W00000XOther Service ProvidersContractor