Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 111493 | TX |
NPI | 1174600498 |
---|---|
Provider Name | Lauren Hammer |
First Address | Vail, CO 81658-7520 |
Second Address | Frisco, CO 80443-5967 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 07/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E04413 | (02) | TX |