Provider Demographics
NPI:1881288314
Name:GREYSON, LAUREL (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:GREYSON
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1834 COOLIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-7045
Mailing Address - Country:US
Mailing Address - Phone:619-980-5569
Mailing Address - Fax:
Practice Address - Street 1:1834 COOLIDGE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-7045
Practice Address - Country:US
Practice Address - Phone:619-980-5569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation