Healthcare Provider Details

I. General information

NPI: 1891019840
Provider Name (Legal Business Name): LAUREN SOFEN SOLEIMANI PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN BETH SOFEN PT, DPT

II. Dates (important events)

Enumeration Date: 03/19/2010
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31045 HUNTERS WHIP LN
FARMINGTON HILLS MI
48331-1538
US

IV. Provider business mailing address

31045 HUNTERS WHIP LN
FARMINGTON HILLS MI
48331-1538
US

V. Phone/Fax

Practice location:
  • Phone: 248-444-0361
  • Fax:
Mailing address:
  • Phone: 248-444-0361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070-017704
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501016476
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number5501016476
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: