Provider Demographics
NPI:1003345927
Name:MICHELLE LEMOINE THERAPY, LLC
Entity Type:Organization
Organization Name:MICHELLE LEMOINE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:BOLTON
Authorized Official - Last Name:LEMOINE
Authorized Official - Suffix:
Authorized Official - Credentials:LORT
Authorized Official - Phone:318-600-6640
Mailing Address - Street 1:2106 N 7TH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-4444
Mailing Address - Country:US
Mailing Address - Phone:318-600-6640
Mailing Address - Fax:318-605-2662
Practice Address - Street 1:2106 N 7TH ST STE 230
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-4444
Practice Address - Country:US
Practice Address - Phone:318-600-6640
Practice Address - Fax:318-605-2662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200-167225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty