Provider Demographics
NPI:1861620361
Name:KLEFFMAN, LAURA MARIE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:MARIE
Last Name:KLEFFMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:MARIE
Other - Last Name:PERRAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5186 UGSTAD RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-9704
Mailing Address - Country:US
Mailing Address - Phone:218-409-2587
Mailing Address - Fax:
Practice Address - Street 1:5186 UGSTAD RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-9704
Practice Address - Country:US
Practice Address - Phone:218-409-2587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT 00003208225XH1200X, 225XP0200X
MN104126225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics