Provider Demographics
NPI:1316265341
Name:LORENZ, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LORENZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1334
Mailing Address - Street 2:
Mailing Address - City:KALAHEO
Mailing Address - State:HI
Mailing Address - Zip Code:96741-1334
Mailing Address - Country:US
Mailing Address - Phone:808-246-2716
Mailing Address - Fax:
Practice Address - Street 1:3-3100 KUHIO HWY STE C13
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1185
Practice Address - Country:US
Practice Address - Phone:808-246-2716
Practice Address - Fax:808-246-2718
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOT999225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist