Provider Demographics
NPI:1922856160
Name:LANEY, DANIEL LEE (COTA/L)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEE
Last Name:LANEY
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 MANOR STONE WAY
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-8898
Mailing Address - Country:US
Mailing Address - Phone:980-245-0000
Mailing Address - Fax:
Practice Address - Street 1:1325 SAGE ST
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-7478
Practice Address - Country:US
Practice Address - Phone:307-362-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTA-1758224Z00000X
NC15812224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant