Provider Demographics
NPI:1083378384
Name:MAYEUX, JESSICA CROWE (MOT, OTR)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:CROWE
Last Name:MAYEUX
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20315 ARCHIE CROWE RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-3165
Mailing Address - Country:US
Mailing Address - Phone:985-515-2311
Mailing Address - Fax:
Practice Address - Street 1:20315 ARCHIE CROWE RD
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-3165
Practice Address - Country:US
Practice Address - Phone:985-515-2311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-24
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA329001225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist