Provider Demographics
NPI:1487806022
Name:GAFNI LACHTER, LIAT ROSE (OTD)
Entity type:Individual
Prefix:DR
First Name:LIAT
Middle Name:ROSE
Last Name:GAFNI LACHTER
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:MS
Other - First Name:LIAT
Other - Middle Name:ROSE
Other - Last Name:LACHTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSC
Mailing Address - Street 1:4601 PARK COMMONS DR
Mailing Address - Street 2:APT. 111
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4984
Mailing Address - Country:US
Mailing Address - Phone:312-320-6266
Mailing Address - Fax:
Practice Address - Street 1:4601 PARK COMMONS DR
Practice Address - Street 2:APT. 111
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-4984
Practice Address - Country:US
Practice Address - Phone:312-320-6266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN105012225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist