Provider Demographics
NPI:1861699910
Name:JUMP, LORI A (OTR)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:JUMP
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 WALDORF PL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2026
Mailing Address - Country:US
Mailing Address - Phone:513-818-4055
Mailing Address - Fax:
Practice Address - Street 1:5900 MEADOW CREEK DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-5641
Practice Address - Country:US
Practice Address - Phone:513-248-7206
Practice Address - Fax:513-248-0466
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03813225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0616533Medicaid