Individual
LAUREN MIKEL FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5954 S QUATAR CT, AURORA, CO 80015-5015
(303) 250-4291
Mailing address
7000 MERCURY TRL, AMARILLO, TX 79118-1502
(832) 794-1562
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10823
TX
Other
Enumeration date
09/30/2014
Last updated
04/22/2021
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