Provider Demographics
NPI:1346563632
Name:PALMER, LAURIE A (OTR)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:A
Last Name:PALMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 37TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4863
Mailing Address - Country:US
Mailing Address - Phone:772-778-2100
Mailing Address - Fax:
Practice Address - Street 1:1600 37TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4863
Practice Address - Country:US
Practice Address - Phone:772-778-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14046225X00000X
TX111582225X00000X
NJ46TR00472700225X00000X
CA9527225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist