Individual
MRS. LACONYA RENE BASNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
8254 ORMAND DR, ZACHARY, LA 70791-7129
(225) 654-2584
Mailing address
8254 ORMAND DR, ZACHARY, LA 70791-7129
(225) 654-2584
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z11819
LA
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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