Individual
LORI ANN DESANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
10 MILLENIUM DR, DUNMORE, PA 18512-2154
(570) 346-6193
Mailing address
10 MILLENIUM ST, DUNMORE, PA 18512-2154
(570) 346-6193
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC006768L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OC006768L
STATE OT LICENSE - PA
PA
Enumeration date
06/16/2010
Last updated
06/16/2010
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