Healthcare Provider Details

I. General information

NPI: 1417851163
Provider Name (Legal Business Name): LAURYN S BARNUM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURYN HICKMAN

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1087 DENNISON AVE
COLUMBUS OH
43201-3201
US

IV. Provider business mailing address

910 WOODHILL DR
COLUMBUS OH
43212-3759
US

V. Phone/Fax

Practice location:
  • Phone: 614-484-9600
  • Fax:
Mailing address:
  • Phone: 614-747-2939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number515270
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: