Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | Z11640 | LA |
Y | 225XH1200X | Occupational Therapist - Hand | Z11640 | LA |
NPI | 1083702401 |
---|---|
Provider Name | Mrs. Angelle Falqoust Brown |
First Address | Baton Rouge, LA 70806-8205 |
Second Address | Baton Rouge, LA 70806-8205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 29/09/2010 |