Provider Demographics
NPI:1063884781
Name:HIIPAKKA, LAUREN (OTR)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HIIPAKKA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4270 S POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-6105
Mailing Address - Country:US
Mailing Address - Phone:307-333-6200
Mailing Address - Fax:307-333-5880
Practice Address - Street 1:4270 S POPLAR ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-6105
Practice Address - Country:US
Practice Address - Phone:307-333-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTR-1153225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist