Individual
MRS. MORGAN ORTEGO BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
313 HERLIL CIR, CARENCRO, LA 70520-5518
(337) 739-5837
(337) 896-2970
Mailing address
313 HERLIL CIR, CARENCRO, LA 70520-5518
(337) 739-5837
(337) 896-2970
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
Z12122
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1304026
—
LA
Enumeration date
05/10/2007
Last updated
07/09/2007
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