Provider Demographics
NPI:1245731538
Name:LEBLANC, LAUREN CLAIRE (OT, MSOT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:CLAIRE
Last Name:LEBLANC
Suffix:
Gender:
Credentials:OT, MSOT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:CLAIRE
Other - Last Name:TOMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-541-5846
Mailing Address - Fax:
Practice Address - Street 1:1205 JOHNSON FERRY RD STE 130
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-5401
Practice Address - Country:US
Practice Address - Phone:770-565-3201
Practice Address - Fax:770-565-3203
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006932225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist