Provider Demographics
NPI:1700449709
Name:WOZNICKI, LAUREN STEFANIE (LMT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:STEFANIE
Last Name:WOZNICKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 15TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-9431
Mailing Address - Country:US
Mailing Address - Phone:541-691-1835
Mailing Address - Fax:
Practice Address - Street 1:1845 HIGHWAY 126 STE H
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9626
Practice Address - Country:US
Practice Address - Phone:541-991-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22524225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist