Organization
OCCUPATIONAL THERAPY SOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAUREN JENNIFER MULLAN M.A., OTR.L (OWNER, O.T. SOUTH)
(704) 843-2020
Entity
Organization
Contact information
Practice address
3022 CHISHOLM CT, WAXHAW, NC 28173-7865
(704) 843-2020
Mailing address
3022 CHISHOLM CT, WAXHAW, NC 28173-7865
(704) 843-2020
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649358862
INDIV. NPI LAUREN MULLAN
NC
05
—
7301928
—
NC
Enumeration date
03/22/2007
Last updated
10/15/2009
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