Provider Demographics
NPI:1922219161
Name:HELGESON, LORIANN (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:LORIANN
Middle Name:
Last Name:HELGESON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 GREEN DR
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-4684
Mailing Address - Country:US
Mailing Address - Phone:208-233-4955
Mailing Address - Fax:
Practice Address - Street 1:IDAHO STATE UNIVERSITY
Practice Address - Street 2:CAMPUS STOP 8045
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83209-0001
Practice Address - Country:US
Practice Address - Phone:208-282-2590
Practice Address - Fax:208-282-4962
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDOT 703225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist