Russel Bienvenu, OT
Individual provider Active NPI Occupational Therapist · Natchitoches, LA
NPI 1194047852 · NPPES record last updated Feb 23, 2010
Key facts
- NPI
- 1194047852
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OTT.Z10858 (LA)
- Practice address
- 101 Isadore St
Natchitoches, LA 71457-5747 - Phone
- (318) 238-2810
- Fax
- (318) 238-2811
- NPI assigned
- Feb 23, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTT.Z10858 | LA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therateam Outpatient Services, LLC | Past | Accepting new patients | |
| Therateam, LLC | Occupational Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTT.Z10858 | LA | Yes |
Addresses
Primary practice location
101 Isadore St
Natchitoches, LA 71457-5747
Mailing address
101 Isadore St
Natchitoches, LA 71457-5747
Phone (318) 238-2810
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTT.Z10858 | Other | LA | LOUISIANA STATE LICENSE |
Other providers in Natchitoches, LA
- Andrea Below
- Dana Bennett
- Jessicus Berry
- Amy Bienvenu
- Joe F Bienvenu
- Bio-Medical Applications of Louisiana, LLC
- Bio-Medical Applications of Louisiana, LLC
- Tracy Jannik Bishop
- Delores Bivens
- Marvin Blake Jr.
All providers in Natchitoches, LA · Occupational Therapist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.