Provider Demographics
NPI:1568963049
Name:LAURIE, ELIZABETH HOLLAND (OTA)
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:HOLLAND
Last Name:LAURIE
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:RENEE
Other - Last Name:HOLLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5700 NW CENTRAL DR STE 350
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-2037
Mailing Address - Country:US
Mailing Address - Phone:832-727-3771
Mailing Address - Fax:888-448-7650
Practice Address - Street 1:1875 POST OAK PARK DR APT 721
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3471
Practice Address - Country:US
Practice Address - Phone:713-419-4803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212676208000000X
212676224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No208000000XAllopathic & Osteopathic PhysiciansPediatrics