Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | LZ10276 | LA |
NPI | 1285624783 |
---|---|
Provider Name | Ms. Arewanda W Douglas |
First Address | Baton Rouge, LA 70807 |
Second Address | Baton Rouge, LA 70807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 18/07/2007 |