Provider Demographics
NPI:1023410628
Name:MILLER, LAUREN O'CONNOR (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:O'CONNOR
Last Name:MILLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:CATHERINE
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5301 PROVIDENCE RD
Mailing Address - Street 2:SUITE 80
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4128
Mailing Address - Country:US
Mailing Address - Phone:757-467-4604
Mailing Address - Fax:757-467-2716
Practice Address - Street 1:5301 PROVIDENCE RD
Practice Address - Street 2:SUITE 80
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4128
Practice Address - Country:US
Practice Address - Phone:757-467-4604
Practice Address - Fax:757-467-2716
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007019225X00000X
SC4366225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics