Individual
GWENN CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1051 ROBERT BLVD, SLIDELL, LA 70458-2011
(985) 643-5630
Mailing address
1051 ROBERT BLVD, SLIDELL, LA 70458-2011
(985) 643-5630
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA Z20398
LA
Other
Enumeration date
01/03/2011
Last updated
01/03/2011
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