Provider Demographics
NPI:1700658119
Name:FERRY, LAURIE REBEKAH
Entity Type:Individual
Prefix:MISS
First Name:LAURIE
Middle Name:REBEKAH
Last Name:FERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LAURIE
Other - Middle Name:REBEKAH
Other - Last Name:PATTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 MILLER RD APT K58
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-1249
Mailing Address - Country:US
Mailing Address - Phone:513-650-0737
Mailing Address - Fax:
Practice Address - Street 1:201 MILLER RD APT K58
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-1249
Practice Address - Country:US
Practice Address - Phone:513-650-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities