Healthcare Provider Details

I. General information

NPI: 1669308615
Provider Name (Legal Business Name): FALEN MCLESTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 HIGHWAY 190 EAST SERVICE RD STE B2
COVINGTON LA
70433-4999
US

IV. Provider business mailing address

5001 HIGHWAY 190 EAST SERVICE RD STE B2
COVINGTON LA
70433-4999
US

V. Phone/Fax

Practice location:
  • Phone: 985-377-6983
  • Fax: 985-333-1657
Mailing address:
  • Phone: 985-377-6983
  • Fax: 985-333-1657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLA10279
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: