Provider Demographics
NPI:1912211707
Name:LANEY, KAREN EILEEN (OTR)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:EILEEN
Last Name:LANEY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11216 IVY CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-6438
Mailing Address - Country:US
Mailing Address - Phone:919-810-2345
Mailing Address - Fax:
Practice Address - Street 1:10810 SANDY OAK LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8386
Practice Address - Country:US
Practice Address - Phone:919-848-2088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4457225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist