Provider Demographics
NPI:1912496050
Name:ANNEN, LAUREN CRANE (OTR/L)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:CRANE
Last Name:ANNEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 S FASHION BLVD
Mailing Address - Street 2:BLDG 5 STE 210
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107
Mailing Address - Country:US
Mailing Address - Phone:833-577-3422
Mailing Address - Fax:
Practice Address - Street 1:5770 S FASHION BLVD
Practice Address - Street 2:BLDG 5 STE 210
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:833-577-3422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11885674-4201225X00000X
CA18471225X00000X
CO5379225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist