Individual
MRS. LORINE STACI FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1008573
OR
225X00000X
Occupational Therapist
46TR00110900
NJ
225X00000X
Occupational Therapist
OC009978
PA
Other
Enumeration date
03/19/2007
Last updated
04/27/2026
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