Provider Demographics
NPI:1093901134
Name:LOCKLIN, DEBORAH C (LOTR)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:LOCKLIN
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 ERNEST BROUSSARD RD
Mailing Address - Street 2:
Mailing Address - City:RAGLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70657-6601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 ERNEST BROUSSARD RD
Practice Address - Street 2:
Practice Address - City:RAGLEY
Practice Address - State:LA
Practice Address - Zip Code:70657-6601
Practice Address - Country:US
Practice Address - Phone:337-725-4948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z10721225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics