Provider Demographics
NPI:1033536099
Name:HESSIAN, LAUREN (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HESSIAN
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 HANOVER PIKE STE G
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-1136
Mailing Address - Country:US
Mailing Address - Phone:410-374-0925
Mailing Address - Fax:
Practice Address - Street 1:2315 HANOVER PIKE STE G
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-1136
Practice Address - Country:US
Practice Address - Phone:410-374-0925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00003822255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer