Healthcare Provider Details

I. General information

NPI: 1891531505
Provider Name (Legal Business Name): LAUREN M LENO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN M BERMAN OTR/L

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S HOLLY AVE
COLLINS MS
39428-3894
US

IV. Provider business mailing address

655 S WILLOW ST STE 128
MANCHESTER NH
03103-5723
US

V. Phone/Fax

Practice location:
  • Phone: 601-765-6711
  • Fax:
Mailing address:
  • Phone: 800-995-2673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0007963
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1073
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT009018
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT4145
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: