Provider Demographics
NPI:1073793998
Name:GAUTHIER, CHRISTINE NICOLLE (OTR)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:NICOLLE
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 SAINT LOUIS ST
Mailing Address - Street 2:APT 102
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-2138
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:528 SAINT LOUIS ST
Practice Address - Street 2:APT 102
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-2138
Practice Address - Country:US
Practice Address - Phone:985-515-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ11718225X00000X
CA10076225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist