Provider Demographics
NPI:1902379365
Name:ADAMS, LAUREL ANN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:ANN
Last Name:ADAMS
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 1:7459 DARTMOOR CT
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-4016
Mailing Address - Country:US
Mailing Address - Phone:248-705-0100
Mailing Address - Fax:
Practice Address - Street 1:1150 MICHIGAN AVE E
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-6163
Practice Address - Country:US
Practice Address - Phone:269-962-5458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006070225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist