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NPI Code Detail

MEDICARE: MRS. BONNIE T LUCIO OT

MEDICARE: MRS. BONNIE T LUCIO OT
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 TherapistZ10451LA

General Provider Information

NPI Number : 1235139072
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BONNIE T LUCIO OT
Provider Business Mailing Address
First Line : 120 RANDOM OAKS LN
Second Line :
City : MANDEVILLE
State : LA
Zip : 70448-4565
Country : US
Telephone Number : 985-624-9956
Fax Number : 985-624-9956
Provider Business Practice Location Address
First Line : 120 RANDOM OAKS LN
Second Line :
City : MANDEVILLE
State : LA
Zip : 70448-4565
Country : US
Telephone Number : 985-624-9956
Fax Number : 985-624-9956
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 08/08/2007

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Directions to “ MRS. BONNIE T LUCIO OT” Practice Location

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