Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OTT.Z10886 | LA |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1104078690 |
---|---|
Provider Name | Anne Breaud |
First Address | New Orleans, LA 70131-3529 |
Second Address | New Orleans, LA 70131-3529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2008 |
Last Update Date | 29/06/2012 |