Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OTT.200397 | LA |
NPI | 1396168969 |
---|---|
Provider Name | Jessie Lalonde |
First Address | Lafayette, LA 70508-8501 |
Second Address | Lafayette, LA 70508-8501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2014 |
Last Update Date | 01/02/2014 |