Healthcare Provider Details

I. General information

NPI: 1174005391
Provider Name (Legal Business Name): RACHELLE DUPLESSIS MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2018
Last Update Date: 09/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9209 CYPRESS LAKE DR
DENHAM SPRINGS LA
70726-9200
US

IV. Provider business mailing address

9209 CYPRESS LAKE DR
DENHAM SPRINGS LA
70726-9200
US

V. Phone/Fax

Practice location:
  • Phone: 504-319-3695
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTT.200769
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: