MEDICARE: MS. LAUREN ASHLEY SYDNOR MS OTR/L

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	225X00000X	Occupational Therapist	14-0519	NV

General Provider Information

NPI Number	:	1518621036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAUREN ASHLEY SYDNOR MS OTR/L

Provider Business Mailing Address
First Line	:	3291 HEIGHTS DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-3824
Country	:	US
Telephone Number	:	954-294-4585
Fax Number	:

Provider Business Practice Location Address
First Line	:	3291 HEIGHTS DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89503-3824
Country	:	US
Telephone Number	:	954-294-4585
Fax Number	:

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

Provider Enumeration Date	:	10/30/2021
Last Update Date	:	10/30/2021

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