Marissa D Mouton, OT | |
109 Wallace Broussard Rd Ste 300a, Carencro, LA 70520-6354 | |
(337) 347-6668 | |
(337) 896-8288 |
Full Name | Marissa D Mouton |
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Gender | Female |
Speciality | Occupational Therapist |
Location | 109 Wallace Broussard Rd Ste 300a, Carencro, Louisiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1982335766 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 331797 (Louisiana) | Primary |
Provider Name | Alvin C Moreau Jr Licensed Physical Therapist Dtd 01 15 82 |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1770568669 PECOS PAC ID: 3173419298 Enrollment ID: O20180207001400 |
Mailing Address | Practice Location Address |
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Marissa D Mouton, OT 1326 Church St, Zachary, LA 70791-2743 Ph: (225) 654-8202 | Marissa D Mouton, OT 109 Wallace Broussard Rd Ste 300a, Carencro, LA 70520-6354 Ph: (337) 347-6668 |
Christopher Matzye, LOTR Occupational Therapist Medicare: Medicare Enrolled Practice Location: 204 E Saint Peter St, Carencro, LA 70520 Phone: 337-896-6686 Fax: 337-565-6003 | |
Mrs. Chalya Rader Dugar, LOTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 102 Spanish Oak Dr, Carencro, LA 70520 Phone: 337-380-6539 | |
Joan B Leger, LOTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 204 E Saint Peter St, Carencro, LA 70520 Phone: 337-896-6686 Fax: 337-565-6003 | |
Miss Mary Bourque, MOT, LOTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 204 E Saint Peter St, Carencro, LA 70520 Phone: 337-896-6686 Fax: 337-565-6003 | |
Mrs. Morgan Ortego Broussard, LOTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 313 Herlil Cir, Carencro, LA 70520 Phone: 337-739-5837 Fax: 337-896-2970 | |
Caroline Bordelon Detraz, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 204 E Saint Peter St, Carencro, LA 70520 Phone: 337-896-6686 Fax: 337-565-6003 | |
Kaitlyn Reaux Johnson, LOTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 204 E Saint Peter St, Carencro, LA 70520 Phone: 337-896-6686 Fax: 337-565-6003 |