Provider Demographics
NPI:1083005557
Name:MEEKER, LAURA KAY (OTA)
Entity type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:KAY
Last Name:MEEKER
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 CLUB VILLAGE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4409
Mailing Address - Country:US
Mailing Address - Phone:573-256-2777
Mailing Address - Fax:
Practice Address - Street 1:1100 CLUB VILLAGE DR
Practice Address - Street 2:SUITE 103
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4409
Practice Address - Country:US
Practice Address - Phone:573-256-2777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015002809224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant