Organization
1720 PEDIATRIC THERAPY
Active
Organization
1720 PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH HILBURN OTR (OWNER-OCCUPATIONAL THERAPIST)
(214) 729-6560
Entity
Organization
Contact information
Practice address
120 MUSCADINE LANE, LAFAYETTE, LA 70508
(214) 729-6560
Mailing address
120 MUSCADINE LANE, LAFAYETTE, LA 70508
(214) 729-6560
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Enumeration date
08/13/2024
Last updated
12/17/2024
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