MEDICARE: LAUREN RAE DAVENPORT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT012397	OH

General Provider Information

NPI Number	:	1154277788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN RAE DAVENPORT

Provider Business Mailing Address
First Line	:	870 W MAIN ST
Second Line	:
City	:	GENEVA
State	:	OH
Zip	:	44041-1219
Country	:	US
Telephone Number	:	440-466-1141
Fax Number	:

Provider Business Practice Location Address
First Line	:	870 W MAIN ST
Second Line	:
City	:	GENEVA
State	:	OH
Zip	:	44041-1219
Country	:	US
Telephone Number	:	440-466-1141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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Directions to “ LAUREN RAE DAVENPORT ” Practice Location

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