Provider Demographics
NPI:1285935858
Name:HAGLIN, LORIE ANN (OTR/H)
Entity type:Individual
Prefix:MRS
First Name:LORIE
Middle Name:ANN
Last Name:HAGLIN
Suffix:
Gender:F
Credentials:OTR/H
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 N. 37TH ST.
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880
Mailing Address - Country:US
Mailing Address - Phone:715-392-5144
Mailing Address - Fax:715-392-1406
Practice Address - Street 1:425 MOULLETTE DR
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-3097
Practice Address - Country:US
Practice Address - Phone:715-651-8045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5719-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist