Healthcare Provider Details

I. General information

NPI: 1508783424
Provider Name (Legal Business Name): MADELYN FUSELIER MOT, LOTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18268 PETROLEUM DR
BATON ROUGE LA
70809-6126
US

IV. Provider business mailing address

17732 HIGHLAND RD STE G
BATON ROUGE LA
70810-3846
US

V. Phone/Fax

Practice location:
  • Phone: 225-292-4138
  • Fax:
Mailing address:
  • Phone: 225-292-4138
  • Fax: 225-636-2940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number352305
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: