Provider Demographics
NPI:1336398254
Name:MORAN, LAUREN FARRELL (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:FARRELL
Last Name:MORAN
Suffix:
Gender:F
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 1:100 JOHN ROBERT THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2652
Mailing Address - Country:US
Mailing Address - Phone:484-557-9541
Mailing Address - Fax:
Practice Address - Street 1:369 N CENTRAL BLVD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3709
Practice Address - Country:US
Practice Address - Phone:610-359-4350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010318225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist