Provider Demographics
NPI:1730415704
Name:BERNARDI, LORI ANN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:BERNARDI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ROSELAND TER
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1128
Mailing Address - Country:US
Mailing Address - Phone:413-297-4884
Mailing Address - Fax:
Practice Address - Street 1:40 ROSELAND TER
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1128
Practice Address - Country:US
Practice Address - Phone:413-297-4884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
MA2871224Z00000X
MA13084225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant