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Individual

LAUREEN MCLAREN COFFELT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
6286 BRIARCREST AVE STE 200, MEMPHIS, TN 38120-4023
(901) 641-3000
(901) 259-1698
Mailing address
6077 PRIMACY PKWY STE 140, MEMPHIS, TN 38119-5742
(901) 725-8347
(901) 259-7637

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
1178
TN
225XH1200X
Hand Occupational Therapist
OT-3879
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
08031211
MS
05
110318002
AR
05
158928721
AR
05
3371161
TN
05
3645198
TN
01
4088730
BLUE CROSS
TN
01
620819926
BCBS
MS
01
620819926
CIGNA
TN
05
7187860
MS
01
7729581
AETNA
TN
01
P00281381
RAILROAD MEDICARE
TN
Enumeration date
05/24/2005
Last updated
07/21/2021
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