Provider Demographics
NPI:1295532000
Name:EVANS, LAURA HORTON (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:HORTON
Last Name:EVANS
Suffix:
Gender:
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4931 HARVEST RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1014
Mailing Address - Country:US
Mailing Address - Phone:719-464-6749
Mailing Address - Fax:
Practice Address - Street 1:2365 PATRIOT HTS
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-5122
Practice Address - Country:US
Practice Address - Phone:719-667-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT0003564225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist