Provider Demographics
NPI:1760199616
Name:LAUGHNER, WILLIAM CLIFFORD III (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CLIFFORD
Last Name:LAUGHNER
Suffix:III
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 E 21ST ST APT 7A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1890
Mailing Address - Country:US
Mailing Address - Phone:740-616-5147
Mailing Address - Fax:
Practice Address - Street 1:62 E 21ST ST APT 7A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1890
Practice Address - Country:US
Practice Address - Phone:740-616-5147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009458-01224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant