Provider Demographics
NPI:1760694244
Name:BURTON, LAURIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:BURTON
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 1:162 SAWTOOTH RD
Mailing Address - Street 2:
Mailing Address - City:GILMANTON
Mailing Address - State:NH
Mailing Address - Zip Code:03237-4511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 PILLSBURY ST
Practice Address - Street 2:SUITE 404
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-3523
Practice Address - Country:US
Practice Address - Phone:603-228-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1029225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30412738Medicaid