Individual
MARY LORENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1402 HIGHWAY 71, INTERNATIONAL FALLS, MN 56649-2154
(763) 689-5385
Mailing address
830 W LINCOLN AVE, FERGUS FALLS, MN 56537-1815
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101130
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
295G3LO
BCBS
MN
01
—
6405524
MEDICA
MN
Enumeration date
09/28/2006
Last updated
07/09/2007
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