MEDICARE: LAUREN NICOLE SIROONIAN OT

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

General Provider Information

NPI Number	:	1477703361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN NICOLE SIROONIAN OT

Provider Business Mailing Address
First Line	:	3355 S TOWN CENTER DR APT 2067
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-3006
Country	:	US
Telephone Number	:	818-825-6149
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 S TOWN CENTER DR APT 2067
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-3006
Country	:	US
Telephone Number	:	818-825-6149
Fax Number	:

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

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	03/01/2010

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