MEDICARE: LAURA M LANIER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist		NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407975063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA M LANIER

Provider Business Mailing Address
First Line	:	3517 ROLLING RD
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-2018
Country	:	US
Telephone Number	:	336-869-4220
Fax Number	:

Provider Business Practice Location Address
First Line	:	3511 W MARKET ST STE B
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27403-4442
Country	:	US
Telephone Number	:	336-294-3338
Fax Number	:	336-294-6696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	08/17/2009

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Directions to “ LAURA M LANIER ” Practice Location

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