Healthcare Provider Details

I. General information

NPI: 1013473370
Provider Name (Legal Business Name): CARLY TEMPLET
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2019
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3971 PHARR ST
METAIRIE LA
70002-4361
US

IV. Provider business mailing address

5004 WILSON DR
METAIRIE LA
70003-2527
US

V. Phone/Fax

Practice location:
  • Phone: 504-401-2275
  • Fax:
Mailing address:
  • Phone: 504-401-2275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA11651
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: