Provider Demographics
NPI:1013430966
Name:HASTINGS, LAURA KATHERINE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHERINE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 CRYSTAL RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-9664
Mailing Address - Country:US
Mailing Address - Phone:716-908-5006
Mailing Address - Fax:
Practice Address - Street 1:4540 CRYSTAL RIDGE CIR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9664
Practice Address - Country:US
Practice Address - Phone:716-908-5006
Practice Address - Fax:716-908-5006
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist