Individual
WHITNEY LANE LUTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1031 E KNOLLWOOD CIR, BLOOMINGTON, IN 47401-4561
(812) 340-9994
Mailing address
8 CLEAVELAND ST APT B, BRUNSWICK, ME 04011-2110
(812) 340-9994
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002661A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22738
—
IN
Enumeration date
06/26/2018
Last updated
01/13/2023
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