Provider Demographics
NPI:1033576715
Name:KEHL, LAUREN
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:KEHL
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 1:5959 LAURA AVE
Mailing Address - Street 2:
Mailing Address - City:HOMEWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44634-9728
Mailing Address - Country:US
Mailing Address - Phone:330-204-9646
Mailing Address - Fax:
Practice Address - Street 1:5959 LAURA AVE
Practice Address - Street 2:
Practice Address - City:HOMEWORTH
Practice Address - State:OH
Practice Address - Zip Code:44634-9728
Practice Address - Country:US
Practice Address - Phone:330-204-9646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3227485224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant