Individual
LAUREN TIREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4160
(260) 435-7244
Mailing address
2009 EMINENCE BREAK PASS, FORT WAYNE, IN 46808-2972
(937) 689-3221
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006367A
IN
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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