Provider Demographics
NPI:1326670258
Name:INTERIAL, LAUREN EVELYN (OTR/L)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:EVELYN
Last Name:INTERIAL
Suffix:
Gender:F
Credentials: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:PO BOX 31473
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33420-1473
Mailing Address - Country:US
Mailing Address - Phone:561-632-0767
Mailing Address - Fax:561-630-6962
Practice Address - Street 1:2051 45TH ST STE 201
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2029
Practice Address - Country:US
Practice Address - Phone:561-632-0767
Practice Address - Fax:561-630-6962
Is Sole Proprietor?:No
Enumeration Date:2020-02-08
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT20666225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist