MEDICARE: COURTNEY MARIE LEVASSEUR OTD, 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
1	225X00000X	Occupational Therapist	123533	TX

General Provider Information

NPI Number	:	1720828973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY MARIE LEVASSEUR OTD, OTR

Provider Business Mailing Address
First Line	:	6607 BRODIE LN APT 1034
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-4654
Country	:	US
Telephone Number	:	804-908-4107
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 FORTVIEW RD STE 103
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-7654
Country	:	US
Telephone Number	:	512-444-4263
Fax Number	:

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

Provider Enumeration Date	:	05/27/2024
Last Update Date	:	05/27/2024

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