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NPI Code Detail

MEDICARE: JOYCELYN LOUISE KIRKENDALL OTR

MEDICARE: JOYCELYN LOUISE KIRKENDALL OTR
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
1225XP0200XPediatric Occupational TherapistOTT.200423LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112405653OTHERLACAQH

General Provider Information

NPI Number : 1447480272
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOYCELYN LOUISE KIRKENDALL OTR
Provider Business Mailing Address
First Line : 4080 NELSON RD STE 500
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70605-2440
Country : US
Telephone Number : 337-497-0434
Fax Number : 337-494-7548
Provider Business Practice Location Address
First Line : 4080 NELSON RD STE 400
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70605-2439
Country : US
Telephone Number : 337-497-0434
Fax Number : 337-494-7548
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2009
Last Update Date : 07/19/2012

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