Healthcare Provider Details

I. General information

NPI: 1346923901
Provider Name (Legal Business Name): FRANCES ALTICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 HUDSON CIR STE 12
MONROE LA
71201-3545
US

IV. Provider business mailing address

1206 FAIRVIEW AVE
MONROE LA
71201-3308
US

V. Phone/Fax

Practice location:
  • Phone: 318-855-3150
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number342686
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: