Individual
MISS TERA MARIE LOVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
2519 COVE AVE, LA GRANDE, OR 97850-3910
(541) 962-0830
Mailing address
247 JORDAN RD, WINLOCK, WA 98596-9672
(360) 880-7026
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
123152
AK
225X00000X
Occupational Therapist
60282840
WA
225X00000X
Occupational Therapist
Primary
—
OR
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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