Provider Demographics
NPI:1528219821
Name:GUILLORY, LAUREN SOILEAU (LOTR)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:SOILEAU
Last Name:GUILLORY
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 HUCKLEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:VILLE PLATTE
Mailing Address - State:LA
Mailing Address - Zip Code:70586-1949
Mailing Address - Country:US
Mailing Address - Phone:337-831-8779
Mailing Address - Fax:
Practice Address - Street 1:1214 HUCKLEBERRY LN
Practice Address - Street 2:
Practice Address - City:VILLE PLATTE
Practice Address - State:LA
Practice Address - Zip Code:70586-1949
Practice Address - Country:US
Practice Address - Phone:337-831-8779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-06
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200120172V00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No172V00000XOther Service ProvidersCommunity Health Worker