Individual
TAMMI REBELLA LAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4 MICHAEL DR, LULING, LA 70070-3112
(504) 417-0281
Mailing address
4 MICHAEL DR, LULING, LA 70070-3112
(504) 417-0281
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTT.Z12356
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1330671
—
LA
Enumeration date
03/12/2007
Last updated
10/05/2023
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