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General NPI Number Information
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NPI Number | 1023410628
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Entity Type | Individual
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Provider Name | LAUREN O'CONNOR MILLER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 12/18/2021
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Provider Practice Location Address
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Address Line | 5301 PROVIDENCE RD SUITE 80
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4128
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Country | US
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Telephone | 757-467-4604
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Fax | 757-467-2716
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Provider Business Mailing Address
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Address Line | 5301 PROVIDENCE RD SUITE 80
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-4128
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Country | US
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Telephone | 757-467-4604
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Fax | 757-467-2716
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119007019
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 4366
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License Number State | SC
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