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NPI Code Detail

MEDICARE: MRS. LESLIE LANUSSE EDWARDS OT

MEDICARE: MRS. LESLIE LANUSSE EDWARDS 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 TherapistOTT.200409LA

General Provider Information

NPI Number : 1336933233
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LESLIE LANUSSE EDWARDS OT
Provider Business Mailing Address
First Line : 5188 HIGHLAND RD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-6527
Country : US
Telephone Number : 225-766-8107
Fax Number :
Provider Business Practice Location Address
First Line : 8316 PICARDY AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3686
Country : US
Telephone Number : 225-767-5032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2025
Last Update Date : 04/07/2025

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