MEDICARE: LAUREN DZICZKOWSKI 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
1	225X00000X	Occupational Therapist	OT.007778	OH

General Provider Information

NPI Number	:	1619233871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN DZICZKOWSKI OTR/L

Provider Business Mailing Address
First Line	:	10055 ARCHER LN
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43017-7038
Country	:	US
Telephone Number	:	614-309-0280
Fax Number	:

Provider Business Practice Location Address
First Line	:	6830 N HIGH ST
Second Line	:
City	:	WORTHINGTON
State	:	OH
Zip	:	43085-2582
Country	:	US
Telephone Number	:	614-888-4553
Fax Number	:

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

Provider Enumeration Date	:	04/02/2012
Last Update Date	:	07/01/2024

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