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General NPI Number Information
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NPI Number | 1104197052
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Entity Type | Individual
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Provider Name | LAUREN VANDERWERF MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 5995 N 78TH ST UNIT 2045
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-6189
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Country | US
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Telephone | 480-215-2494
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Fax |
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Provider Business Mailing Address
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Address Line | 2006 E HAZELTINE WAY
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City | GILBERT
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State | AZ
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Zip | 85298-7467
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Country | US
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Telephone | 480-215-2494
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Fax |
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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 | 5015
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License Number State | AZ
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