Provider Demographics
NPI:1316363732
Name:MYERS, LAURIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10529 NEWBURG RD
Mailing Address - Street 2:
Mailing Address - City:ORRSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17244-9637
Mailing Address - Country:US
Mailing Address - Phone:717-860-9781
Mailing Address - Fax:
Practice Address - Street 1:10529 NEWBURG RD
Practice Address - Street 2:
Practice Address - City:ORRSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17244-9637
Practice Address - Country:US
Practice Address - Phone:717-860-9781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP007817224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant