Organization
FUNCTIONAL LIVING SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANYELLE JOHNSON LOTR, MOT (OCCUPATIONAL THERAPIST)
(337) 459-6591
Entity
Organization
Contact information
Practice address
938 MARTEAU RD, BROUSSARD, LA 70518-7907
(337) 459-6591
Mailing address
938 MARTEAU RD, BROUSSARD, LA 70518-7907
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730771080
NA
—
Enumeration date
02/21/2021
Last updated
02/21/2021
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