Individual
LAUREN ASHLEY BONASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
140 CARRIAGE CLUB DR, MOORESVILLE, NC 28117-9284
(704) 658-1200
Mailing address
6000 HAMPTON CTR, STE B, MORGANTOWN, WV 26505-1748
(304) 599-1500
(304) 599-7800
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1489
WV
225X00000X
Occupational Therapist
8676
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4005078000
—
WV
Enumeration date
07/28/2010
Last updated
07/07/2022
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