Provider Demographics
NPI:1033508338
Name:DUVERNAY, CHRISTIE ANN
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:ANN
Last Name:DUVERNAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12311 MORRISON RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-4508
Mailing Address - Country:US
Mailing Address - Phone:504-452-1819
Mailing Address - Fax:
Practice Address - Street 1:1125 MARGUERITE ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1855
Practice Address - Country:US
Practice Address - Phone:504-452-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT/200768225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist