Basic Information
| Provider Information | |||||||||
| NPI: | 1790455616 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KLUGHERZ | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | ALAYNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3541 ENSIGN AVE N | ||||||||
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| City: | NEW HOPE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554271725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6122052691 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2400 W 64TH ST | ||||||||
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| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554231001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6127677222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2021 | ||||||||
| LastUpdateDate: | 09/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.