Laura Lynn Beach, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Caldwell, TX

NPI 1942591003 · NPPES record last updated Apr 25, 2011

Key facts

NPI
1942591003
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
211157 (TX)
Practice address
1022 State Highway 21 E
Caldwell, TX 77836-4611
Phone
(979) 567-8408
NPI assigned
Apr 25, 2011
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

LicenseStateTypeSpecialty
2010026802MOMDOccupational Therapy Assistant
211157TXMDOccupational Therapy Assistant
4730-027WIMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 211157 TX Yes
Occupational Therapy Assistant 224Z00000X 4730-027 WI
Occupational Therapy Assistant 224Z00000X 2010026802 MO

Addresses

Primary practice location

1022 State Highway 21 E
Caldwell, TX 77836-4611

Mailing address

1022 State Highway 21 E
Caldwell, TX 77836-4611
Phone (979) 567-8408

Other providers in Caldwell, TX

All providers in Caldwell, TX · Occupational Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.