| NPI | 1184277568 |
|---|---|
| Former Name | LAUREN ELISE PEDERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NE 2484) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CO OT.0006057) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2021-01-21 |