Provider Demographics
NPI:1376858340
Name:COUTTS, LAUREN MICHELE (MOT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:MICHELE
Last Name:COUTTS
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 MULBERRY DR
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-6129
Mailing Address - Country:US
Mailing Address - Phone:954-263-3936
Mailing Address - Fax:
Practice Address - Street 1:5709 MULBERRY DR
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-6129
Practice Address - Country:US
Practice Address - Phone:954-263-3936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTT14228225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist