Individual
TRACI MARIE PONDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4612 CLEARLAKE DR, METAIRIE, LA 70006-2222
(504) 439-4808
Mailing address
4612 CLEARLAKE DR, METAIRIE, LA 70006-2222
(504) 439-4808
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200552
LA
Other
Enumeration date
02/06/2013
Last updated
02/24/2023
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