Provider Demographics
NPI:1396123519
Name:DOTSON, LORI (OT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:DOTSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 LEWIS DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-7723
Mailing Address - Country:US
Mailing Address - Phone:859-200-2608
Mailing Address - Fax:
Practice Address - Street 1:273 SHOPPERS DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-2806
Practice Address - Country:US
Practice Address - Phone:859-745-7995
Practice Address - Fax:859-745-0115
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKYR3432174400000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174400000XOther Service ProvidersSpecialist