Provider Demographics
NPI:1790207256
Name:VESPER, LAUREN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:VESPER
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 1:6 BROKEN ARROW RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-6702
Mailing Address - Country:US
Mailing Address - Phone:908-723-1761
Mailing Address - Fax:
Practice Address - Street 1:6 BROKEN ARROW RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-6702
Practice Address - Country:US
Practice Address - Phone:908-723-1761
Practice Address - Fax:908-723-1761
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-16
Last Update Date:2017-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007383225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation