Organization
SPECTRUM THERAPY SOLUTIONS
Active
Organization
SPECTRUM THERAPY SOLUTIONS
Active
Other names
Pediatric Therapy Solutions
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANIELLE SIMONE MIXON LOTR (OWNER)
(225) 622-7208
Entity
Organization
Contact information
Practice address
40235 HIGHWAY 42 STE B, PRAIRIEVILLE, LA 70769-5244
(225) 622-7208
(225) 622-7208
Mailing address
16314 WINDING RIDGE AVE, PRAIRIEVILLE, LA 70769-3446
(225) 622-7208
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
Z11958
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194757740
NPPES
LA
Enumeration date
04/07/2015
Last updated
04/07/2015
Update your record
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