Provider Demographics
NPI:1740626407
Name:HANLIN, LORI MICHELLE (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:LORI
Middle Name:MICHELLE
Last Name:HANLIN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 LONGVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MINGO JCT
Mailing Address - State:OH
Mailing Address - Zip Code:43938-1458
Mailing Address - Country:US
Mailing Address - Phone:740-275-4614
Mailing Address - Fax:
Practice Address - Street 1:305 LONGVIEW AVE
Practice Address - Street 2:
Practice Address - City:MINGO JCT
Practice Address - State:OH
Practice Address - Zip Code:43938-1458
Practice Address - Country:US
Practice Address - Phone:740-275-4614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVC1899224Z00000X
PAOP007592224Z00000X
OH05349224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant