Provider Demographics
NPI:1245553007
Name:O'NAN, LAURA H (COTA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:H
Last Name:O'NAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2349 OLD MADISONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:KY
Mailing Address - Zip Code:42450
Mailing Address - Country:US
Mailing Address - Phone:270-667-7989
Mailing Address - Fax:
Practice Address - Street 1:11550 N.MERIDIAN ST
Practice Address - Street 2:SUITE 312
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:800-570-8806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY267426224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant