Provider Demographics
NPI:1154586956
Name:MATSON, LAURIE JANAY (OTR/L)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:JANAY
Last Name:MATSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 COLLEGE RD
Mailing Address - Street 2:EASTER SEALS FLORIDA KEYS REGIONAL OFFICE
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4302
Mailing Address - Country:US
Mailing Address - Phone:305-294-1089
Mailing Address - Fax:305-296-1530
Practice Address - Street 1:5220 COLLEGE RD
Practice Address - Street 2:EASTER SEALS FLORIDA KEYS REGIONAL OFFICE
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4302
Practice Address - Country:US
Practice Address - Phone:305-294-1089
Practice Address - Fax:305-296-1530
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13221225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist