Individual
KANDICE BIRDSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, LOTR
Contact information
Practice address
104 W 134TH ST, CUT OFF, LA 70345-4155
(985) 632-7919
Mailing address
104 W 134TH ST, CUT OFF, LA 70345-4155
(985) 632-7919
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200467
LA
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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