Provider Demographics
NPI:1740160936
Name:FOLSE, LORI G (OT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:G
Last Name:FOLSE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:G
Other - Last Name:SHINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:4205 BLACKHAWK DR
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-3762
Mailing Address - Country:US
Mailing Address - Phone:409-370-3970
Mailing Address - Fax:
Practice Address - Street 1:4205 BLACKHAWK DR
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-3762
Practice Address - Country:US
Practice Address - Phone:409-370-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109843225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist