Provider Demographics
NPI:1558578526
Name:MEADE, LORI MICHELLE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:MICHELLE
Last Name:MEADE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:MICHELLE
Other - Last Name:ROTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4106 BROOKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:ORWIGSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17961-9308
Mailing Address - Country:US
Mailing Address - Phone:570-590-5338
Mailing Address - Fax:
Practice Address - Street 1:1000 SETON DR
Practice Address - Street 2:
Practice Address - City:ORWIGSBURG
Practice Address - State:PA
Practice Address - Zip Code:17961-1009
Practice Address - Country:US
Practice Address - Phone:570-366-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP001375L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant