Provider Demographics
NPI:1669543245
Name:MOHR, LUCY M (CPED)
Entity type:Individual
Prefix:
First Name:LUCY
Middle Name:M
Last Name:MOHR
Suffix:
Gender:F
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 ROBIN HOOD TRL
Mailing Address - Street 2:
Mailing Address - City:OCEAN PINES
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1687
Mailing Address - Country:US
Mailing Address - Phone:410-641-6400
Mailing Address - Fax:
Practice Address - Street 1:104 ROBIN HOOD TRL
Practice Address - Street 2:
Practice Address - City:OCEAN PINES
Practice Address - State:MD
Practice Address - Zip Code:21811-1687
Practice Address - Country:US
Practice Address - Phone:410-641-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCPED0653225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter