Individual
LORI FAYE LIBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR,L/CHT
Contact information
Practice address
1610 GROVER ST STE B2, LYNDEN, WA 98264-1539
(360) 354-5245
(360) 354-7796
Mailing address
624 E MABERRY DR, LYNDEN, WA 98264-9337
(360) 354-0201
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00000415
WA
225XH1200X
Hand Occupational Therapist
OT00000415
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8340549
—
WA
Enumeration date
06/28/2006
Last updated
09/11/2025
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