Provider Demographics
NPI:1215056049
Name:LAUER, AILEEN KAY (CMT, COMT, CAMTC)
Entity type:Individual
Prefix:MS
First Name:AILEEN
Middle Name:KAY
Last Name:LAUER
Suffix:
Gender:F
Credentials:CMT, COMT, CAMTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 J ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-4748
Mailing Address - Country:US
Mailing Address - Phone:916-204-3393
Mailing Address - Fax:
Practice Address - Street 1:2301 J ST
Practice Address - Street 2:SUITE 203
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-4748
Practice Address - Country:US
Practice Address - Phone:916-204-3393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77067174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist