Healthcare Provider Details

I. General information

NPI: 1871413880
Provider Name (Legal Business Name): BRAKEFIELD & CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12615 LAZY OAKS DR
BASTROP LA
71220-7564
US

IV. Provider business mailing address

12615 LAZY OAKS DR
BASTROP LA
71220-7564
US

V. Phone/Fax

Practice location:
  • Phone: 318-348-2331
  • Fax:
Mailing address:
  • Phone: 318-348-2331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA LYNN BRAKEFIELD
Title or Position: COTA/L
Credential: OWNER
Phone: 318-348-2331