MEDICARE: REBEKAH R SOILEAU OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	311807	LA

General Provider Information

NPI Number	:	1386296598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBEKAH R SOILEAU OT

Provider Business Mailing Address
First Line	:	4211 LAKE ST STE 20
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 LAKE ST STE 20
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5001
Country	:	US
Telephone Number	:	337-270-2424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	09/10/2025

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