Provider Demographics
NPI:1457030157
Name:SPELL, LAUREN PREDDY (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:PREDDY
Last Name:SPELL
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3498 MOUNT MORIAH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-0539
Mailing Address - Country:US
Mailing Address - Phone:910-214-5375
Mailing Address - Fax:
Practice Address - Street 1:232 BEAMAN ST UNIT B
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2906
Practice Address - Country:US
Practice Address - Phone:910-590-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15183225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist