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Individual
LAUREN DOUGLAS
Active
Individual
LAUREN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2416460
GA
225X00000X
Occupational Therapist
Primary
4945
SC
225XP0200X
Pediatric Occupational Therapist
4945
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
02/11/2014
Last updated
09/27/2021
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