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General NPI Number Information
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NPI Number | 1285190801
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Entity Type | Individual
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Provider Name | MADISON RALPH BOHTE LOTR
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Gender | Female
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Dates
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Enumeration Date | 02/19/2019
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 3013 27TH ST
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City | METAIRIE
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State | LA
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Zip | 70002-6013
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Country | US
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Telephone | 504-291-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 4213 LUCERNE ST
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City | METAIRIE
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State | LA
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Zip | 70006-2443
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Country | US
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Telephone | 251-786-0247
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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