Healthcare Provider Details

I. General information

NPI: 1396220257
Provider Name (Legal Business Name): LAUREN STEEN OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
Deactivation Date: 04/10/2024
Reactivation Date: 04/24/2024

III. Provider practice location address

4285 DEVELOPMENT DR
LANSING MI
48911-4213
US

IV. Provider business mailing address

4285 DEVELOPMENT DR
LANSING MI
48911-4213
US

V. Phone/Fax

Practice location:
  • Phone: 517-706-0421
  • Fax:
Mailing address:
  • Phone: 517-706-0421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number5201013778
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: