Provider Demographics
NPI:1003937483
Name:REES, LAUREN K
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:K
Last Name:REES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 TARRAGON DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-3669
Mailing Address - Country:US
Mailing Address - Phone:317-889-0932
Mailing Address - Fax:317-889-0932
Practice Address - Street 1:4409 TARRAGON DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-3669
Practice Address - Country:US
Practice Address - Phone:317-889-0932
Practice Address - Fax:317-889-0932
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003812A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200683520OtherFIRST STEPS