Amy R Alfonso, LOTR

Individual provider Active NPI Occupational Therapist · Mandeville, LA

NPI 1407082233 · NPPES record last updated Jun 8, 2009

Key facts

NPI
1407082233
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OTT Z12081 (LA)
Practice address
665 Plantation Blvd
Mandeville, LA 70448-7500
Phone
(985) 624-4934
NPI assigned
Jun 8, 2009
Sex
Female
Sole proprietor
Yes

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
OTT Z12081LAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTT Z12081 LA Yes

Addresses

Primary practice location

665 Plantation Blvd
Mandeville, LA 70448-7500

Mailing address

665 Plantation Blvd
Mandeville, LA 70448-7500
Phone (985) 624-4934

Other providers in Mandeville, LA

All providers in Mandeville, LA · Occupational Therapist in Louisiana

Sources for this page

Verify at the official NPI Registry.