Provider Demographics
NPI:1467778712
Name:HERRELL, LAURA LYNN (OTD,OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:LYNN
Last Name:HERRELL
Suffix:
Gender:F
Credentials:OTD,OTR/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10824 TOPANGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1350
Mailing Address - Country:US
Mailing Address - Phone:818-882-0200
Mailing Address - Fax:866-443-1985
Practice Address - Street 1:10824 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-1350
Practice Address - Country:US
Practice Address - Phone:818-882-0200
Practice Address - Fax:866-443-1985
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA10905225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist