Provider Demographics
NPI:1699105296
Name:O'DAY, LAUREN NICHOLE
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:NICHOLE
Last Name:O'DAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:DE
Mailing Address - Zip Code:19940-1110
Mailing Address - Country:US
Mailing Address - Phone:302-846-3077
Mailing Address - Fax:302-846-3478
Practice Address - Street 1:101 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-1110
Practice Address - Country:US
Practice Address - Phone:302-846-3077
Practice Address - Fax:302-846-3478
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU20001252224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant