Provider Demographics
NPI:1518412758
Name:LERCH, LAURYN LYNAE (COTA/L)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:LYNAE
Last Name:LERCH
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 E STATION AVE
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-2027
Mailing Address - Country:US
Mailing Address - Phone:484-863-9220
Mailing Address - Fax:
Practice Address - Street 1:551 E STATION AVE
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-2027
Practice Address - Country:US
Practice Address - Phone:484-863-9220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA364015224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant