Provider Demographics
NPI:1740421650
Name:GLASSBRENNER, LORI ANN (MOTR/L)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANN
Last Name:GLASSBRENNER
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 HARTS RD
Mailing Address - Street 2:
Mailing Address - City:EVANS CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16033-3151
Mailing Address - Country:US
Mailing Address - Phone:724-513-1516
Mailing Address - Fax:
Practice Address - Street 1:97 HARTS RD
Practice Address - Street 2:
Practice Address - City:EVANS CITY
Practice Address - State:PA
Practice Address - Zip Code:16033-3151
Practice Address - Country:US
Practice Address - Phone:724-513-1516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008311225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist