Healthcare Provider Details

I. General information

NPI: 1033045745
Provider Name (Legal Business Name): JENNA CAZAYOUX SMITH LOTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64030 HIGHWAY 434
LACOMBE LA
70445-3405
US

IV. Provider business mailing address

520 MYRTLE DR APT 1203
COVINGTON LA
70433-8263
US

V. Phone/Fax

Practice location:
  • Phone: 985-218-4660
  • Fax:
Mailing address:
  • Phone: 225-718-5013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number352437
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: