Individual
MRS. ANGIE COOK DEHARDE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
85 WHISPERWOOD BLVD, SLIDELL, LA 70458-1136
(985) 641-2866
(985) 781-5395
Mailing address
85 WHISPERWOOD BLVD, SLIDELL, LA 70458-1136
(985) 641-2866
(985) 781-5395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06416
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H2868
BLUECROSS BLUESHIELD
LA
Enumeration date
06/17/2006
Last updated
07/08/2007
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