Individual
LAUREN MARIE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2011 CORONA RD STE 301, COLUMBIA, MO 65203-2548
(314) 543-3861
Mailing address
725 DEMARET DR, APT A, COLUMBIA, MO 65202-3043
(573) 639-2242
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2011014298
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011014298
STATE LICENSURE
MO
Enumeration date
03/02/2012
Last updated
03/05/2012
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