Provider Demographics
NPI:1457590184
Name:GREINER, LAURIE JEAN (KAYLA GREINER)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:JEAN
Last Name:GREINER
Suffix:
Gender:F
Credentials:KAYLA GREINER
Other - Prefix:MISS
Other - First Name:LAURIE
Other - Middle Name:JEAN
Other - Last Name:LEMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:PO BOX 1166
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-1166
Mailing Address - Country:US
Mailing Address - Phone:918-323-2052
Mailing Address - Fax:
Practice Address - Street 1:23557 S 4390 RD
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-5371
Practice Address - Country:US
Practice Address - Phone:918-323-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT227225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist