Provider Demographics
NPI:1851518740
Name:DALZIEL, LORRAINE D (OTD)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:D
Last Name:DALZIEL
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 N 164TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68118-2452
Mailing Address - Country:US
Mailing Address - Phone:402-932-1444
Mailing Address - Fax:
Practice Address - Street 1:1702 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3652
Practice Address - Country:US
Practice Address - Phone:402-682-4214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1219225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist