Provider Demographics
NPI:1336744002
Name:TEBRINK, LAUREN BRITTANY (OTR/L)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BRITTANY
Last Name:TEBRINK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:BRITTANY
Other - Last Name:PEPPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:109 QUARRY ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-1318
Mailing Address - Country:US
Mailing Address - Phone:636-544-2283
Mailing Address - Fax:
Practice Address - Street 1:21 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WAUKON
Practice Address - State:IA
Practice Address - Zip Code:52172-1748
Practice Address - Country:US
Practice Address - Phone:563-568-3447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002358225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist