Provider Demographics
NPI:1023236817
Name:MORA, ELIZABETH ANN (OTR)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:MORA
Suffix:
Gender:F
Credentials:OTR
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Mailing Address - Street 1:1720 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1604
Mailing Address - Country:US
Mailing Address - Phone:219-655-5108
Mailing Address - Fax:219-322-9787
Practice Address - Street 1:221 US HIGHWAY 41
Practice Address - Street 2:SUITE G
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-1277
Practice Address - Country:US
Practice Address - Phone:219-322-2037
Practice Address - Fax:219-322-9787
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN31000837A225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics