Provider Demographics
NPI:1073097093
Name:DIGIOVANNI, LAUREN ELAINE (LMT, DC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELAINE
Last Name:DIGIOVANNI
Suffix:
Gender:F
Credentials:LMT, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 HIGH ST STE B
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3962
Mailing Address - Country:US
Mailing Address - Phone:614-396-6945
Mailing Address - Fax:
Practice Address - Street 1:510 HIGH ST STE B
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3962
Practice Address - Country:US
Practice Address - Phone:614-396-6945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH05202111N00000X
NY208989225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY028989OtherLICENSED MASSAGE THERAPIST