Provider Demographics
NPI:1710765375
Name:HOLAHAN, LAUREN (PHD, OT/L)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:HOLAHAN
Suffix:
Gender:F
Credentials:PHD, OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4428 GUESS RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-2620
Mailing Address - Country:US
Mailing Address - Phone:919-428-7201
Mailing Address - Fax:
Practice Address - Street 1:4428 GUESS RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-2620
Practice Address - Country:US
Practice Address - Phone:919-428-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2795225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics