Provider Demographics
NPI:1588006480
Name:THIELE, LAUREN RACHEL (MOT, OTR)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:RACHEL
Last Name:THIELE
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8188 WASHINGTON STREET
Mailing Address - Street 2:#101
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1724 MAJESTIC DR
Practice Address - Street 2:SUITE # 109
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8510
Practice Address - Country:US
Practice Address - Phone:303-665-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist