Basic Information
| Provider Information | |||||||||
| NPI: | 1154586956 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATSON | ||||||||
| FirstName: | LAURIE | ||||||||
| MiddleName: | JANAY | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5220 COLLEGE RD | ||||||||
| Address2: | EASTER SEALS FLORIDA KEYS REGIONAL OFFICE | ||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330404302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052941089 | ||||||||
| FaxNumber: | 3052961530 | ||||||||
| Practice Location | |||||||||
| Address1: | 5220 COLLEGE RD | ||||||||
| Address2: | EASTER SEALS FLORIDA KEYS REGIONAL OFFICE | ||||||||
| City: | KEY WEST | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330404302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052941089 | ||||||||
| FaxNumber: | 3052961530 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2008 | ||||||||
| LastUpdateDate: | 07/22/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 13221 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.