Individual
LORI ANN CULLOTTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008170
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932114
BCBS ILLINOIS
IL
05
—
LB04761207P
—
IL
Enumeration date
10/15/2007
Last updated
04/02/2012
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