Individual
EMILY RUTH HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
125 LAKE POWELL DR, WEST MONROE, LA 71292-2107
(318) 381-9356
Mailing address
125 LAKE POWELL DR, WEST MONROE, LA 71292-2107
(318) 381-9356
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
305554
LA
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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