Healthcare Provider Details

I. General information

NPI: 1811850704
Provider Name (Legal Business Name): SYDNEY CLAIRE RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15151 BAHIA CT
COVINGTON LA
70435-1500
US

IV. Provider business mailing address

15151 BAHIA CT
COVINGTON LA
70435-1500
US

V. Phone/Fax

Practice location:
  • Phone: 985-515-8193
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number340916
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: