Healthcare Provider Details

I. General information

NPI: 1427805464
Provider Name (Legal Business Name): OTABA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 HOSPITAL AVE
FRANKLIN LA
70538-3721
US

IV. Provider business mailing address

4422 IRISH BEND RD
FRANKLIN LA
70538-3146
US

V. Phone/Fax

Practice location:
  • Phone: 337-578-5016
  • Fax:
Mailing address:
  • Phone: 337-578-5016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. APRILL C. PAYTON
Title or Position: OWNER/MANAGER
Credential: MOTR
Phone: 337-578-5016