Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 07887 | LA |
NPI | 1477139053 |
---|---|
Provider Name | Melissa Naquin |
First Address | Gretna, LA 70056-7365 |
Second Address | Gretna, LA 70056-7365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2021 |
Last Update Date | 23/03/2021 |