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General NPI Number Information
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NPI Number | 1720462963
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Entity Type | Individual
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Provider Name | LAUREN DRYDEN
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Gender | Female
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Dates
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Enumeration Date | 07/17/2015
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 760 RED CLAY DR
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City | BEAR
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State | DE
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Zip | 19701-1059
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Country | US
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Telephone | 302-898-0034
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Fax |
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Provider Business Mailing Address
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Address Line | 760 RED CLAY DR
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City | BEAR
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State | DE
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Zip | 19701-1059
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Country | US
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Telephone | 302-898-0034
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | U2-0001349
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License Number State | DE
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