Healthcare Provider Details

I. General information

NPI: 1124702147
Provider Name (Legal Business Name): GABRIELLE SCIONEAUX OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 RUE IBERVILLE
LAFAYETTE LA
70508-3295
US

IV. Provider business mailing address

9701 N SAM HOUSTON PKWY E STE 120
HUMBLE TX
77396-4693
US

V. Phone/Fax

Practice location:
  • Phone: 337-521-7000
  • Fax:
Mailing address:
  • Phone: 832-639-4066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number352586
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: