Provider Demographics
NPI:1528386562
Name:JOACHIM, LAUREN BETH (MA, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BETH
Last Name:JOACHIM
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 GLEN HILL LN
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5055
Mailing Address - Country:US
Mailing Address - Phone:646-483-1410
Mailing Address - Fax:
Practice Address - Street 1:15 GLEN HILL LN
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5055
Practice Address - Country:US
Practice Address - Phone:646-483-1410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004986225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics