Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1043825466 |
---|---|
Provider Name | Mrs. Lori Michelle Loughlin |
First Address | Kingston, MA 02364-1471 |
Second Address | Kingston, MA 02364-1471 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2020 |
Last Update Date | 11/09/2020 |