Provider Demographics
NPI:1669833786
Name:WALKER, LORI (OT/L)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 OLD BRICKYARD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-8971
Mailing Address - Country:US
Mailing Address - Phone:336-667-3986
Mailing Address - Fax:
Practice Address - Street 1:204 OLD BRICKYARD RD
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-8971
Practice Address - Country:US
Practice Address - Phone:336-667-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4380225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist