Provider Demographics
NPI:1932496684
Name:MANN, LAUREN (OTRL)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10668 LYDIA LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72833-6890
Mailing Address - Country:US
Mailing Address - Phone:479-393-1138
Mailing Address - Fax:479-495-2622
Practice Address - Street 1:10668 LYDIA LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:AR
Practice Address - Zip Code:72833-6890
Practice Address - Country:US
Practice Address - Phone:479-393-1138
Practice Address - Fax:479-495-2622
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225X00000X
AROTR2443225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist