Healthcare Provider Details

I. General information

NPI: 1952318503
Provider Name (Legal Business Name): MEGAN KING COMEAUX O.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 05/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N COLLEGE RD STE. #3 & 4
LAFAYETTE LA
70506-4263
US

IV. Provider business mailing address

6209 CAMERON ST LOT 16
SCOTT LA
70583-5194
US

V. Phone/Fax

Practice location:
  • Phone: 337-233-5230
  • Fax: 337-233-5270
Mailing address:
  • Phone: 318-614-8692
  • Fax: 337-233-5270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTT-.200072
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: