Provider Demographics
NPI:1962646695
Name:ABBOTT, LAURIE KATHLEEN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:KATHLEEN
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1601 EASTMAN AVENUE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003
Mailing Address - Country:US
Mailing Address - Phone:805-650-6290
Mailing Address - Fax:805-650-6912
Practice Address - Street 1:1601 EASTMAN AVENUE
Practice Address - Street 2:SUITE 103
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-650-6290
Practice Address - Fax:805-650-6912
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0T1631225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics