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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LORI B GUSTAFSON, PTA

Active

LORI B GUSTAFSON, PTA is a Occupational Therapist healthcare provider located in VALLEY HEAD, Alabama. NPI 1861952194 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · VALLEY HEAD, AL

Registration Details

NPI Number
1861952194
Provider Type
Individual
Gender
Female
NPI Issued
Mar 22, 2019 (7.3603565601875 yrs)
Last Updated
May 3, 2021
Licenses
7501 (TN)
PTA10177 (AL)
14-03493 (KS)
PTA004592 (GA)

Practice Information

Address
3034 COUNTY ROAD 611
VALLEY HEAD, AL, 359894623
Browse AL providers · Browse ZIP 35989
Phone
9129963567
Fax
8552328604
Primary Specialty
Occupational Therapist
225200000X
Additional Specialty
Occupational Therapist
Additional Specialty
Occupational Therapist
Additional Specialty
Occupational Therapist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.