Provider Demographics
NPI:1306227608
Name:PATTON, LAUREN E (MSOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:E
Last Name:PATTON
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 S COLUMBUS ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4206
Mailing Address - Country:US
Mailing Address - Phone:908-672-1241
Mailing Address - Fax:
Practice Address - Street 1:821 S COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4206
Practice Address - Country:US
Practice Address - Phone:908-672-1241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119006365225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist