Ellen Moosa, LOTR

Individual provider Active NPI Occupational Therapist · Lafayette, LA

NPI 1033690995 · NPPES record last updated Aug 28, 2018

Key facts

NPI
1033690995
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
310571 (LA)
Practice address
108 Energy Pkwy
Lafayette, LA 70508-3818
Phone
(337) 504-4244
Fax
(337) 706-7612
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
310571LAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 310571 LA Yes

Addresses

Primary practice location

108 Energy Pkwy
Lafayette, LA 70508-3818

Mailing address

108 Energy Pkwy
Lafayette, LA 70508-3818
Phone (337) 504-4244

Other providers in Lafayette, LA

All providers in Lafayette, LA · Occupational Therapist in Louisiana

Sources for this page

Verify at the official NPI Registry.