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NPI Code Detail

MEDICARE: MRS. CHARLOTTE ANNE ANDERSON OTA

MEDICARE:  MRS. CHARLOTTE ANNE ANDERSON  OTA
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
1224Z00000XOccupational Therapy AssistantZ20579LA

General Provider Information

NPI Number : 1679846273
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHARLOTTE ANNE ANDERSON OTA
Provider Business Mailing Address
First Line : 2238 WINDSOR CT
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-5442
Country : US
Telephone Number : 318-272-0693
Fax Number :
Provider Business Practice Location Address
First Line : 2238 WINDSOR CT
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-5442
Country : US
Telephone Number : 318-272-0693
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2012
Last Update Date : 02/14/2012

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Directions to “ MRS. CHARLOTTE ANNE ANDERSON OTA” Practice Location

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