Provider Demographics
NPI:1144345265
Name:KLING, LAURIE LYNN (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:MISS
First Name:LAURIE
Middle Name:LYNN
Last Name:KLING
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:
Other - Last Name:CUNNINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10251 NORTH 35TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051
Mailing Address - Country:US
Mailing Address - Phone:602-995-7366
Mailing Address - Fax:602-995-0867
Practice Address - Street 1:10251 NORTH 35TH AVENUE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051
Practice Address - Country:US
Practice Address - Phone:602-995-7366
Practice Address - Fax:602-995-0867
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
100758225X00000X
NM1682225X00000X
AZ4243225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist