Basic Information
Provider Information
NPI: 1285027532
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLEW
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHAUFLER
OtherFirstName: LAUREN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 528 HETTLE RD
Address2:  
City: WILLARD
State: OH
PostalCode: 448909051
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2701 CHESTNUT STATION CT
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402996395
CountryCode: US
TelephoneNumber: 8003351060
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/11/2015
LastUpdateDate: 03/11/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT-8948OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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