Provider Demographics
NPI:1962517334
Name:MICHAELS, LAURI R (OTR/L, CHT)
Entity type:Individual
Prefix:MS
First Name:LAURI
Middle Name:R
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 20TH ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-2043
Mailing Address - Country:US
Mailing Address - Phone:310-453-2120
Mailing Address - Fax:
Practice Address - Street 1:810 20TH ST
Practice Address - Street 2:APT. 2
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2043
Practice Address - Country:US
Practice Address - Phone:310-453-2120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 2663225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand