Provider Demographics
NPI:1831639558
Name:KEEHN, LAUREN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:KEEHN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:515 S 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HAUBSTADT
Mailing Address - State:IN
Mailing Address - Zip Code:47639-8237
Mailing Address - Country:US
Mailing Address - Phone:812-779-4318
Mailing Address - Fax:
Practice Address - Street 1:1112 OAK ST
Practice Address - Street 2:
Practice Address - City:CARMI
Practice Address - State:IL
Practice Address - Zip Code:62821-1344
Practice Address - Country:US
Practice Address - Phone:618-382-2927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171447225X00000X
IN31006229A225X00000X
IL056.011780225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist