Kenneth Charles Dean
Occupational Therapist - Gerontology
8924 Bayonne Dr
Shreveport
, Louisiana 71118-2033
Kenneth Charles Dean
Occupational Therapist - Gerontology
8924 Bayonne Dr
Shreveport
, Louisiana 71118-2033
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About
Features
Specialties
- Occupational Therapist - Gerontology
Languages spoken
- English
Location
First Address
- Kenneth Charles Dean
- 127 W Broad St
- Lake Charles, LA
- Zip : 70601-4393
- Phone :
Second Address
- Kenneth Charles Dean
- 8924 Bayonne Dr
- Shreveport, LA
- Zip : 71118-2033
- Phone : (318) 294-1952
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XG0600X | Occupational Therapist - Gerontology | 214817 | TX |
National Provider Identifier
| NPI | 1184188435 |
|---|---|
| Provider Name | Kenneth Charles Dean |
| First Address | Lake Charles, LA 70601-4393 |
| Second Address | Shreveport, LA 71118-2033 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/01/2019 |
| Last Update Date | 30/01/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.