Provider Demographics
NPI:1992401509
Name:LAXTON, LORI LEIGH (COTA/L)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:LEIGH
Last Name:LAXTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1769 ROBERT C BYRD DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-8707
Mailing Address - Country:US
Mailing Address - Phone:304-860-1048
Mailing Address - Fax:304-860-1049
Practice Address - Street 1:1769 ROBERT C BYRD DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-8707
Practice Address - Country:US
Practice Address - Phone:304-860-1048
Practice Address - Fax:304-860-1049
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVC1825224ZE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224ZE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantEnvironmental Modification