Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 322107 | LA |
NPI | 1194351361 |
---|---|
Provider Name | Mrs. Caroline Robichaux Boone |
First Address | Hoover, AL 35242-5424 |
Second Address | Raceland, LA 70394-2644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2020 |
Last Update Date | 01/10/2020 |