Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | Z10816 | LA |
NPI | 1598851107 |
---|---|
Provider Name | Mr. Danny Dee Dauzat |
First Address | Dry Prong, LA 71423 |
Second Address | Dry Prong, LA 71423 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |