Healthcare Provider Details

I. General information

NPI: 1376696542
Provider Name (Legal Business Name): NEURO TECHNOLOGY INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 S SHERWOOD FOREST BLVD STE 247
BATON ROUGE LA
70816-2255
US

IV. Provider business mailing address

3535 S SHERWOOD FOREST BLVD STE 247
BATON ROUGE LA
70816-2255
US

V. Phone/Fax

Practice location:
  • Phone: 225-293-6222
  • Fax: 225-208-1100
Mailing address:
  • Phone: 225-293-6222
  • Fax: 225-208-1100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBIN L LEBEAU
Title or Position: GENERAL MANAGER
Credential:
Phone: 225-293-6222