Provider Demographics
NPI:1750618526
Name:LEWIS, ANN M (OTR/L)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:LEWIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-6075
Mailing Address - Country:US
Mailing Address - Phone:802-888-7907
Mailing Address - Fax:
Practice Address - Street 1:54 FARR AVE
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-9181
Practice Address - Country:US
Practice Address - Phone:802-888-7907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-15
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT072-0000293225X00000X
CT003519225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist