Provider Demographics
NPI:1023348737
Name:LABONNE, LAURA LEE RIECK (OTR)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE RIECK
Last Name:LABONNE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:RIECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1415 LINCOLNWAY W STE M
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-2061
Practice Address - Country:US
Practice Address - Phone:574-675-7767
Practice Address - Fax:574-675-9344
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001089A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist