Caroline Bordelon Detraz, | |
204 E Saint Peter St, Carencro, LA 70520-4009 | |
(337) 896-6686 | |
(337) 565-6003 |
Full Name | Caroline Bordelon Detraz |
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Gender | Female |
Speciality | Occupational Therapist |
Location | 204 E Saint Peter St, 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 |
---|---|---|---|
1598748741 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 2806 (South Carolina) | Secondary |
225X00000X | Occupational Therapist | OTT.200079 (Louisiana) | Primary |
Provider Name | Therapy Center Of Jefferson Davis Parish, Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1508971045 PECOS PAC ID: 0345207544 Enrollment ID: O20050120000627 |
Mailing Address | Practice Location Address |
---|---|
Caroline Bordelon Detraz, 2002 Johnson St, Suite 100, Jennings, LA 70546-3640 Ph: (337) 824-4547 | Caroline Bordelon Detraz, 204 E Saint Peter St, Carencro, LA 70520-4009 Ph: (337) 896-6686 |
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 | |
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 |