Provider Demographics
NPI:1073968632
Name:INTEGRATIVE TOUCH PEDIATRIC OCCUPATIONAL THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:INTEGRATIVE TOUCH PEDIATRIC OCCUPATIONAL THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TAMMI
Authorized Official - Middle Name:REBELLA
Authorized Official - Last Name:LAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:LOTR
Authorized Official - Phone:504-417-0281
Mailing Address - Street 1:2655 N CAUSEWAY BLVD
Mailing Address - Street 2:STE. D
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-6435
Mailing Address - Country:US
Mailing Address - Phone:985-871-6777
Mailing Address - Fax:985-871-6777
Practice Address - Street 1:4 MICHAEL DR
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-3112
Practice Address - Country:US
Practice Address - Phone:504-417-0281
Practice Address - Fax:504-417-0281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTZ.12356261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty