Individual
SHANA MATHERNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13343 WEST MAIN STREET, LAROSE, LA 70373
(985) 798-7557
Mailing address
P.O. BOX 159, LAROSE, LA 70373
(985) 798-7557
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
LA
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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