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Organization

ST NICHOLAS PEDIATRIC EVAUATIONS AND THERAPY SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA R HESSON OTR/L (OCCUPATIONAL THERAPIST/ OWNER)
(985) 502-8853
Entity
Organization

Contact information

Practice address
109 CONSTELLATION DR, SLIDELL, LA 70458-9029
(985) 502-8853
(985) 288-4572
Mailing address
109 CONSTELLATION DR, SLIDELL, LA 70458-9029
(985) 502-8853
(985) 288-4572

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT1528
MS
225XP0200X
Pediatric Occupational Therapist
Primary
OT1528
MS

Other

Enumeration date
05/16/2013
Last updated
05/16/2013
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