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General NPI Number Information
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NPI Number | 1588484398
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Entity Type | Individual
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Provider Name | JORDAN BADEAUX
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Gender | Female
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 3975 I 49 S SERVICE RD
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City | OPELOUSAS
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State | LA
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Zip | 70570-0775
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Country | US
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Telephone | 337-948-2218
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Fax |
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Provider Business Mailing Address
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Address Line | 495 NAP LN
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City | OPELOUSAS
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State | LA
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Zip | 70570-4686
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Country | US
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Telephone |
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 340752
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License Number State | LA
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