Provider Demographics
NPI:1831475490
Name:POEPPE, LAUREN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:POEPPE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:CHRONISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:64 SUNNY HILL CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-2623
Mailing Address - Country:US
Mailing Address - Phone:314-541-4056
Mailing Address - Fax:
Practice Address - Street 1:456 N. NEW BALLAS RD
Practice Address - Street 2:STE 211
Practice Address - City:CREVE COEUR
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-277-2124
Practice Address - Fax:515-727-8757
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002166225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist