Healthcare Provider Details

I. General information

NPI: 1124948062
Provider Name (Legal Business Name): LAUREN HOLMES OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 W 64TH ST STE 125
OVERLAND PARK KS
66202-4007
US

IV. Provider business mailing address

6701 W 64TH ST STE 125
OVERLAND PARK KS
66202-4007
US

V. Phone/Fax

Practice location:
  • Phone: 913-789-9900
  • Fax: 913-789-9900
Mailing address:
  • Phone: 913-789-9900
  • Fax: 913-789-9900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17-04633
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: