Provider Demographics
NPI:1306290531
Name:MUSICK, LAUREN (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MUSICK
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 REMINGTON ST
Mailing Address - Street 2:APT 1
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3370
Mailing Address - Country:US
Mailing Address - Phone:850-380-4077
Mailing Address - Fax:
Practice Address - Street 1:3780 N GARFIELD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2233
Practice Address - Country:US
Practice Address - Phone:970-663-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0004556225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist