Provider Demographics
NPI:1871066282
Name:DEAN, LAUREN (COTA/L)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:PEDDICORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4338 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3129
Mailing Address - Country:US
Mailing Address - Phone:513-288-4220
Mailing Address - Fax:
Practice Address - Street 1:9370 UNION CEMETERY RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-9577
Practice Address - Country:US
Practice Address - Phone:513-677-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA007078224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant