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General NPI Number Information
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NPI Number | 1720828197
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Entity Type | Individual
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Provider Name | HANNAH LABOYTEAUX
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Gender | Female
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 2004 S MEMORIAL DR
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City | NEW CASTLE
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State | IN
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Zip | 47362-1220
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Country | US
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Telephone | 765-212-0116
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Fax |
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Provider Business Mailing Address
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Address Line | 919 LINCOLN AVE
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City | NEW CASTLE
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State | IN
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Zip | 47362-4761
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT22207732
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License Number State | IN
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