Provider Demographics
NPI:1710189287
Name:PAQUETTE, LORRAINE (OTR)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:PAQUETTE
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:PO BOX 2302
Mailing Address - Street 2:
Mailing Address - City:SALOME
Mailing Address - State:AZ
Mailing Address - Zip Code:85348-2302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10304 N HAYDEN RD
Practice Address - Street 2:SUITE 8
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1217
Practice Address - Country:US
Practice Address - Phone:480-429-5266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0302OtherLICENSE#