Healthcare Provider Details

I. General information

NPI: 1144894502
Provider Name (Legal Business Name): HEATHER DEVILLIER MOT/LOTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 FIDELITY ST
SAINT FRANCISVILLE LA
70775-4333
US

IV. Provider business mailing address

PO BOX 1910
SAINT FRANCISVILLE LA
70775-1910
US

V. Phone/Fax

Practice location:
  • Phone: 225-635-3891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: