Provider Demographics
NPI:1457535585
Name:FEEST, LAURIE (OTR,CHT,LLCC)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:
Last Name:FEEST
Suffix:
Gender:F
Credentials:OTR,CHT,LLCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CIVIC CENTER LN
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-5607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 CIVIC CENTER LN
Practice Address - Street 2:HAVASU REGIONAL MEDICAL CENTER
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-3030
Practice Address - Country:US
Practice Address - Phone:928-453-0411
Practice Address - Fax:928-453-0418
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3162225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand