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NPI Code Detail

MEDICARE: CHRISTINE NICOLLE GAUTHIER OTR

MEDICARE:   CHRISTINE NICOLLE GAUTHIER  OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistZ11718LA
2225X00000XOccupational Therapist10076CA

General Provider Information

NPI Number : 1073793998
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE NICOLLE GAUTHIER OTR
Provider Business Mailing Address
First Line : 528 SAINT LOUIS ST
Second Line : APT 102
City : NEW ORLEANS
State : LA
Zip : 70130-2138
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 528 SAINT LOUIS ST
Second Line : APT 102
City : NEW ORLEANS
State : LA
Zip : 70130-2138
Country : US
Telephone Number : 985-515-4747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2007
Last Update Date : 03/20/2019

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Directions to “ CHRISTINE NICOLLE GAUTHIER OTR” Practice Location

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