Basic Information
Provider Information
NPI: 1942546288
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARKLE
FirstName: LAUREN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MS, OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1741 ASHLAND AVE
Address2:  
City: BALTIMORE
State: MD
PostalCode: 21205
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 707 N. BROADWAY
Address2:  
City: BALTIMORE
State: MD
PostalCode: 21205
CountryCode: US
TelephoneNumber: 4439239200
FaxNumber: 4104218923
Other Information
ProviderEnumerationDate: 12/13/2012
LastUpdateDate: 08/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/25/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225XP0200X06938MDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics

No ID Information.


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