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Individual

NICOLE R. BAROUSSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT, LOTR

Contact information

Practice address
2390 W CONGRESS ST, LAFAYETTE, LA 70506-4205
(337) 261-6709
(337) 261-6749
Mailing address
100 GARDEN GROVE DR, LAFAYETTE, LA 70506-7108
(337) 989-1997

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z11634
LA

Other

Enumeration date
07/15/2009
Last updated
07/15/2009
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