Healthcare Provider Details

I. General information

NPI: 1982217741
Provider Name (Legal Business Name): LAUREN SKOLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 PEARLCROFT RD
CHERRY HILL NJ
08034-3334
US

IV. Provider business mailing address

132 PEARLCROFT RD
CHERRY HILL NJ
08034-3334
US

V. Phone/Fax

Practice location:
  • Phone: 856-630-3397
  • Fax:
Mailing address:
  • Phone: 856-630-3397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number46TR00905000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: