Healthcare Provider Details

I. General information

NPI: 1861314486
Provider Name (Legal Business Name): MONIQUE ALEXA JIMENO OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 CURRAN BLVD
NEW ORLEANS LA
70127-1304
US

IV. Provider business mailing address

733 LEONTINE ST
NEW ORLEANS LA
70115-1934
US

V. Phone/Fax

Practice location:
  • Phone: 504-367-3307
  • Fax:
Mailing address:
  • Phone: 786-474-0401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number352482
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: