Provider Demographics
NPI:1124493150
Name:BUCHAN, LAUREN (COTA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BUCHAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 PRINTZ AVE
Mailing Address - Street 2:
Mailing Address - City:ESSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19029-1313
Mailing Address - Country:US
Mailing Address - Phone:610-998-5484
Mailing Address - Fax:
Practice Address - Street 1:402 PRINTZ AVE
Practice Address - Street 2:
Practice Address - City:ESSINGTON
Practice Address - State:PA
Practice Address - Zip Code:19029-1313
Practice Address - Country:US
Practice Address - Phone:610-296-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP008340224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant