Provider Demographics
NPI:1932236841
Name:DRICK, LAURIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:DRICK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:ALLENWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:17810-9426
Mailing Address - Country:US
Mailing Address - Phone:570-372-2384
Mailing Address - Fax:
Practice Address - Street 1:51 ROUTE 204
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-8066
Practice Address - Country:US
Practice Address - Phone:570-372-2384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004203L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist