Provider Demographics
NPI:1457423261
Name:O'STEEN, LORI (OTA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:O'STEEN
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9222 CR 417
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32060
Mailing Address - Country:US
Mailing Address - Phone:386-658-5865
Mailing Address - Fax:386-658-5542
Practice Address - Street 1:10820 MARVIN E. JONES BLVD.
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32060
Practice Address - Country:US
Practice Address - Phone:386-658-5865
Practice Address - Fax:386-658-5542
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA9830224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant