MEDICARE: TAYLOR CHEYENNE DUBOIS MOT, LOTR

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
1	225X00000X	Occupational Therapist	340104	LA

General Provider Information

NPI Number	:	1417802927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR CHEYENNE DUBOIS MOT, LOTR

Provider Business Mailing Address
First Line	:	404 FORTY OAKS FARM RD
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-9097
Country	:	US
Telephone Number	:	318-608-9823
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 FORTY OAKS FARM RD
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-9097
Country	:	US
Telephone Number	:	318-608-9823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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