Provider Demographics
NPI:1053649715
Name:PRUSNEK, LORI L (OT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:L
Last Name:PRUSNEK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:L
Other - Last Name:WATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 BRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-5463
Mailing Address - Country:US
Mailing Address - Phone:419-425-6786
Mailing Address - Fax:419-425-8570
Practice Address - Street 1:1501 BRIGHT RD
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-5463
Practice Address - Country:US
Practice Address - Phone:419-425-6786
Practice Address - Fax:419-425-8570
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist