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
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