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General NPI Number Information
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NPI Number | 1356182653
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Entity Type | Individual
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Provider Name | COURTNEY MARIE ROBERTS MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 2106 RUE SIMONE
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City | HAMMOND
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State | LA
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Zip | 70403-5728
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Country | US
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Telephone | 985-662-5448
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Fax |
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Provider Business Mailing Address
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Address Line | 112 WESTMINSTER DR
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City | SLIDELL
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State | LA
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Zip | 70460-8405
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Country | US
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Telephone | 504-427-6270
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 341822
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License Number State | LA
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