Provider Demographics
NPI:1730378548
Name:JAMES, LAURA GOTTMAN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:GOTTMAN
Last Name:JAMES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FALLING LEAF DR
Mailing Address - Street 2:
Mailing Address - City:LAKE SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63367-6431
Mailing Address - Country:US
Mailing Address - Phone:636-887-0074
Mailing Address - Fax:
Practice Address - Street 1:4 FALLING LEAF DR
Practice Address - Street 2:
Practice Address - City:LAKE SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-6431
Practice Address - Country:US
Practice Address - Phone:636-887-0074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999138384225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist