Healthcare Provider Details

I. General information

NPI: 1528227600
Provider Name (Legal Business Name): BARRILLEAUX & ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2008
Last Update Date: 12/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56369 CURRIER LANE
LORANGER LA
70446-2749
US

IV. Provider business mailing address

56369 CURRIER LANE
LORANGER LA
70446-2749
US

V. Phone/Fax

Practice location:
  • Phone: 985-606-0341
  • Fax: 985-878-9751
Mailing address:
  • Phone: 985-606-0341
  • Fax: 985-878-9781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number1749936001
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1749936001
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1749936001
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number1749936001
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number1749936001
License Number StateLA

VIII. Authorized Official

Name: MR. VERNON E. BARRILLEAUX
Title or Position: PRESIDENT, CFO
Credential:
Phone: 985-606-0341