Provider Demographics
NPI:1770863599
Name:BROWN, LAURIE ADDISON (OTR/L)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ADDISON
Last Name:BROWN
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 1:342 MIRAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-1211
Mailing Address - Country:US
Mailing Address - Phone:614-558-0357
Mailing Address - Fax:
Practice Address - Street 1:342 MIRAMAR AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-1211
Practice Address - Country:US
Practice Address - Phone:614-558-0357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003813225XP0200X
CA10572225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics