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Individual

MRS. LORRIE C KANOZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
560 S LOOP RD, SECOND FLOOR, EDGEWOOD, KY 41017-3405
(859) 301-5540
Mailing address
560 S LOOP RD, SECOND FLOOR, EDGEWOOD, KY 41017-3405
(859) 301-5540

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT 01591
OH
225XH1200X
Hand Occupational Therapist
R5087
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000344794
ANTHEM
OH
05
2507095
OH
01
P00325332
MEDICARE RAILROAD
OH
Enumeration date
07/13/2005
Last updated
02/06/2017
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