Lauren Kathleen Calloway, COTA
Individual provider Active NPI Occupational Therapy Assistant · Azle, TX
NPI 1770133993 · NPPES record last updated Sep 19, 2019
Key facts
- NPI
- 1770133993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 215874 (TX)
- Practice address
- 721 Dunaway LN
Azle, TX 76020-2605 - Phone
- (817) 444-2536
- NPI assigned
- Sep 19, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 215874 | TX | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 215874 | TX | Yes |
Addresses
Primary practice location
721 Dunaway LN
Azle, TX 76020-2605
Mailing address
1705 SE 11TH St
Mineral Wells, TX 76067-6609
Phone (817) 629-0077
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All providers in Azle, TX · Occupational Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.