Basic Information
| Provider Information | |||||||||
| NPI: | 1548639164 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOLMAR | ||||||||
| FirstName: | LAURIN | ||||||||
| MiddleName: | SUZANNE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | OT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SCHISLER | ||||||||
| OtherFirstName: | LAURIN | ||||||||
| OtherMiddleName: | SUZANNE | ||||||||
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| OtherCredential: | OT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1201 HIGHWAY 49 SOUTH | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | RICHLAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392189438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7692338844 | ||||||||
| FaxNumber: | 7692511825 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 HIGHWAY 49 S STE 2 | ||||||||
| Address2: | |||||||||
| City: | RICHLAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 392189438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622894311 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/24/2015 | ||||||||
| LastUpdateDate: | 06/13/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 3114 | MS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.