Healthcare Provider Details

I. General information

NPI: 1003707449
Provider Name (Legal Business Name): ABIGAIL CUDD OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1727 IMPERIAL BLVD BLDG 3
LAKE CHARLES LA
70605-5393
US

IV. Provider business mailing address

1727 IMPERIAL BLVD BLDG 3
LAKE CHARLES LA
70605-5393
US

V. Phone/Fax

Practice location:
  • Phone: 337-478-5880
  • Fax: 337-478-5879
Mailing address:
  • Phone: 337-478-5880
  • Fax: 337-478-5879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number348288
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: