Individual
MR. JAIME MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LOTR,CHT
Contact information
Practice address
2727 KALISTE SALOOM RD, SUITE 101, LAFAYETTE, LA 70508-7151
(337) 981-4053
(337) 981-2448
Mailing address
PO BOX 52522, LAFAYETTE, LA 70505-2522
(337) 981-4053
(337) 981-2448
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z12097
LA
Other
Enumeration date
07/26/2005
Last updated
07/15/2008
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