Shana Matherne

Individual provider Active NPI Occupational Therapy Assistant · Larose, LA

NPI 1447425335 · NPPES record last updated Apr 23, 2008

Key facts

NPI
1447425335
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Practice address
13343 West Main Street
Larose, LA 70373
Phone
(985) 798-7557
NPI assigned
Apr 23, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
007239034LAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therex Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X LA Yes

Addresses

Primary practice location

13343 West Main Street
Larose, LA 70373

Mailing address

P.O. Box 159
Larose, LA 70373
Phone (985) 798-7557

Other providers in Larose, LA

All providers in Larose, LA · Occupational Therapy Assistant in Louisiana

Sources for this page

Verify at the official NPI Registry.