Healthcare Provider Details

I. General information

NPI: 1477498244
Provider Name (Legal Business Name): VICTORIA ACOSTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 LEBLANC RD
DUSON LA
70529-4410
US

IV. Provider business mailing address

633 LEBLANC RD
DUSON LA
70529-4410
US

V. Phone/Fax

Practice location:
  • Phone: 337-247-1691
  • Fax:
Mailing address:
  • Phone: 337-247-1691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLA9412
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: