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NPI Code Detail

MEDICARE: MRS. LAUREN WALLIN M.S., OTR/L

MEDICARE: MRS. LAUREN WALLIN M.S., OTR/L
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
1225X00000XOccupational Therapist1461ND

General Provider Information

NPI Number : 1538529805
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAUREN WALLIN M.S., OTR/L
Provider Business Mailing Address
First Line : 1929 N WASHINGTON ST STE GG
Second Line :
City : BISMARCK
State : ND
Zip : 58501-1669
Country : US
Telephone Number : 701-751-3732
Fax Number :
Provider Business Practice Location Address
First Line : 1929 N WASHINGTON ST STE GG
Second Line :
City : BISMARCK
State : ND
Zip : 58501-1669
Country : US
Telephone Number : 701-751-3732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2016
Last Update Date : 09/03/2020

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