Individual
LAUREN STODDART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OCCUPATIONAL THERP
Contact information
Practice address
302 E 24TH ST, BRYAN, TX 77803-5303
(979) 822-6467
(979) 821-9448
Mailing address
302 E. 24TH ST, P.O. BOX 4588, BRYAN, TX 77805-4588
(979) 822-6467
(979) 821-9448
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107005
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005330801
—
TX
Enumeration date
03/01/2007
Last updated
07/09/2007
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