Provider Demographics
NPI:1861134678
Name:LORENZEN, ERIKA NICOLE (OTR/L)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:NICOLE
Last Name:LORENZEN
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 1:375 SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:44865-1135
Mailing Address - Country:US
Mailing Address - Phone:419-508-5716
Mailing Address - Fax:
Practice Address - Street 1:890 W 4TH ST STE 100
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-2561
Practice Address - Country:US
Practice Address - Phone:419-774-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011894225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist