Provider Demographics
NPI:1194432872
Name:LOCKHART, LAURA LEE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14555 PHILIPPINE ST APT 1116
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-7820
Mailing Address - Country:US
Mailing Address - Phone:409-489-6030
Mailing Address - Fax:
Practice Address - Street 1:14555 PHILIPPINE ST APT 1116
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-7820
Practice Address - Country:US
Practice Address - Phone:409-489-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217450224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant