Healthcare Provider Details

I. General information

NPI: 1861339277
Provider Name (Legal Business Name): ELIZABETH HATTIER PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2026
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 MEDICAL CENTER DR
SLIDELL LA
70461-5575
US

IV. Provider business mailing address

104 MEDICAL CENTER DR
SLIDELL LA
70461-5575
US

V. Phone/Fax

Practice location:
  • Phone: 985-646-5921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number12146
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: