Individual
MS. KAITLYN FONTENOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOT, LOTR
Contact information
Practice address
1388 CREOSOTE LN, MAMOU, LA 70554-4739
(337) 459-6990
Mailing address
1388 CREOSOTE LN, MAMOU, LA 70554-4739
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
323078
LA
Other
Enumeration date
08/14/2022
Last updated
08/14/2022
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