Healthcare Provider Details

I. General information

NPI: 1891301107
Provider Name (Legal Business Name): LAUREN ELIZABETH ROBINSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 09/22/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5268 NICHOLSON LN STE A
KENSINGTON MD
20895-1010
US

IV. Provider business mailing address

12113 MAGNOLIA PARK PL
CLARKSBURG MD
20871-4472
US

V. Phone/Fax

Practice location:
  • Phone: 301-770-5437
  • Fax:
Mailing address:
  • Phone: 301-471-4542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number09123
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: