Provider Demographics
NPI:1659607679
Name:ALLEN, LAURIE ANNE (OT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANNE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8309 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37924-4102
Mailing Address - Country:US
Mailing Address - Phone:865-932-1334
Mailing Address - Fax:865-932-1374
Practice Address - Street 1:8309 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37924-4102
Practice Address - Country:US
Practice Address - Phone:865-932-1334
Practice Address - Fax:865-932-1374
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4117225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist