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NPI Code Detail

MEDICARE: DANIELLE ROUSSEL OT

MEDICARE:   DANIELLE  ROUSSEL  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
1225X00000XOccupational TherapistOT.200458LA

General Provider Information

NPI Number : 1619710779
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE ROUSSEL OT
Provider Business Mailing Address
First Line : 53 MAGNOLIA RIDGE DR
Second Line :
City : MADISONVILLE
State : LA
Zip : 70447-9791
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2000 COVINGTON CTR
Second Line :
City : COVINGTON
State : LA
Zip : 70433-2979
Country : US
Telephone Number : 985-237-1921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2024
Last Update Date : 06/17/2024

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