Individual
MRS. LAUREN FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.O.T.R., C.H.T.
Contact information
Practice address
17709 OLD JEFFERSON HWY STE A, PRAIRIEVILLE, LA 70769-3977
(225) 677-8400
(225) 677-8484
Mailing address
17709 OLD JEFFERSON HWY STE A, PRAIRIEVILLE, LA 70769-3977
(225) 677-8400
(225) 677-8484
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z10470
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212607
COVENTRY
LA
Enumeration date
11/03/2006
Last updated
03/17/2018
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