Individual
KAITLYN BONVILLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1003 SAINT MARY ST, THIBODAUX, LA 70301-6624
(985) 227-9116
(985) 227-9259
Mailing address
1003 SAINT MARY ST, THIBODAUX, LA 70301-6624
(985) 227-9116
(985) 227-9259
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
331043
LA
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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