Provider Demographics
NPI:1477987410
Name:WATTS, LAUREN (OT/L)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:WATTS
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 HARTS NECK RD
Mailing Address - Street 2:
Mailing Address - City:TENANTS HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04860-5624
Mailing Address - Country:US
Mailing Address - Phone:207-372-8511
Mailing Address - Fax:
Practice Address - Street 1:28 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2940
Practice Address - Country:US
Practice Address - Phone:207-596-6620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT573225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist