Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 116320 | TX |
N | 225XE0001X | Environmental Modification | 116320 | TX |
N | 225XF0002X | Feeding, Eating & Swallowing | 116320 | TX |
N | 2251H1300X | Human Factors | 116320 | TX |
N | 225XH1300X | Human Factors | 116320 | TX |
N | 225XM0800X | Mental Health | 116320 | TX |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 116320 | TX |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 116320 | TX |
NPI | 1003367129 |
---|---|
Provider Name | Lauryn Lax |
First Address | Austin, TX 78723-5457 |
Second Address | Austin, TX 78702-4604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2016 |
Last Update Date | 24/10/2016 |