Individual
CAROLINE BORDELON DETRAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 E SAINT PETER ST, CARENCRO, LA 70520-4009
(337) 896-6686
(337) 565-6003
Mailing address
2002 JOHNSON ST, SUITE 100, JENNINGS, LA 70546-3640
(337) 824-4547
(337) 824-4548
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2806
SC
225X00000X
Occupational Therapist
Primary
OTT.200079
LA
Other
Enumeration date
11/22/2005
Last updated
02/22/2017
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