Individual
DERRICK A. TOWNSEND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
2346 S RANGE AVE, DENHAM SPRINGS, LA 70726-5216
(225) 665-8080
(225) 665-0999
Mailing address
2346 S RANGE AVE, DENHAM SPRINGS, LA 70726-5216
(225) 665-8080
(225) 665-0999
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200258
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTT.200258
STATE LICENSE
LA
Enumeration date
08/21/2008
Last updated
08/21/2008
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