Provider Demographics
NPI:1801104286
Name:LOHR, CYNTHIA ANN (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:ANN
Last Name:LOHR
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 1:203 PACKARD ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-4764
Mailing Address - Country:US
Mailing Address - Phone:217-369-9503
Mailing Address - Fax:
Practice Address - Street 1:1507 7TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:IL
Practice Address - Zip Code:62656-2216
Practice Address - Country:US
Practice Address - Phone:217-732-4826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-19
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057.002833174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist