Provider Demographics
NPI:1790002681
Name:SANDHU, LAUREN DALE (OTR)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:DALE
Last Name:SANDHU
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-3428
Mailing Address - Country:US
Mailing Address - Phone:972-365-7648
Mailing Address - Fax:
Practice Address - Street 1:737 ROBIN LN
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3428
Practice Address - Country:US
Practice Address - Phone:972-365-7648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110117225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist