Provider Demographics
NPI:1649228693
Name:HALL, LAURA MEYER (OTR/L)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MEYER
Last Name:HALL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 BLUEBELL CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-6601
Mailing Address - Country:US
Mailing Address - Phone:910-796-6656
Mailing Address - Fax:910-796-6656
Practice Address - Street 1:3602 BLUEBELL CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-6601
Practice Address - Country:US
Practice Address - Phone:910-796-6656
Practice Address - Fax:910-796-6656
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC581225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC682308OtherUNITED HEALTH CARE
NC7301367Medicaid
NC12517OtherBCBS PROVIDER NUMBER