Provider Demographics
NPI:1346748381
Name:BROWN, LAUREN (MOT, OTRL)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MOT, OTRL
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:BOVENZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6625 DALY RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3410
Mailing Address - Country:US
Mailing Address - Phone:248-737-3430
Mailing Address - Fax:248-737-3433
Practice Address - Street 1:6625 DALY RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3410
Practice Address - Country:US
Practice Address - Phone:248-737-3430
Practice Address - Fax:248-737-3433
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201009927225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics