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General NPI Number Information
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NPI Number | 1447536966
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Entity Type | Individual
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Provider Name | HALEY MONETTE DESHOTEL O.T.
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Gender | Female
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Dates
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Enumeration Date | 10/28/2011
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Last Update Date | 10/28/2011
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Provider Practice Location Address
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Address Line | 1605 7TH ST
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City | MAMOU
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State | LA
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Zip | 70554-2221
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Country | US
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Telephone | 337-468-4685
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Fax | 337-468-4699
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Provider Business Mailing Address
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Address Line | PO BOX 929
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City | PINE PRAIRIE
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State | LA
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Zip | 70576-0929
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Country | US
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Telephone | 337-523-0178
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Fax | 337-468-4699
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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 | OTT.Z12231
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License Number State | LA
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