Provider Demographics
NPI:1063040160
Name:SALENS, LAUREN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SALENS
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 1:1950 E WATTLES RD STE 108
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-5079
Mailing Address - Country:US
Mailing Address - Phone:248-606-0551
Mailing Address - Fax:248-928-5051
Practice Address - Street 1:1950 E WATTLES RD STE 108
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-5079
Practice Address - Country:US
Practice Address - Phone:248-606-0551
Practice Address - Fax:248-928-5051
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI520101755225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist