MEDICARE: OPTIMAL THERAPY SOLUTIONS, LLC

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1407553811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMAL THERAPY SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	72286 KUSTENMACHER RD
Second Line	:
City	:	ABITA SPRINGS
State	:	LA
Zip	:	70420-3508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	72286 KUSTENMACHER RD
Second Line	:
City	:	ABITA SPRINGS
State	:	LA
Zip	:	70420-3508
Country	:	US
Telephone Number	:	985-463-6890
Fax Number	:

Authorized Official
Title or Position	:	OWNER/SPEECH-LANGUAGE PATHOLOGIST
Name	:	MRS. RACHEL MARQUARDT
Credential	:	M.A., CCC-SLP
Telephone Number	:	985-463-6890

Provider Enumeration Date	:	02/15/2023
Last Update Date	:	02/15/2023

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