Provider Demographics
NPI:1770029076
Name:MCCOY, LAUREN MOORE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:MOORE
Last Name:MCCOY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3905 UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707
Mailing Address - Country:US
Mailing Address - Phone:919-928-0204
Mailing Address - Fax:919-928-9423
Practice Address - Street 1:3905 UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-928-0204
Practice Address - Fax:919-928-9423
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10171225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist