Provider Demographics
NPI:1114078938
Name:JARREAU, ALISHA HEBERT (DPT)
Entity Type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:HEBERT
Last Name:JARREAU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:ALISHA
Other - Middle Name:
Other - Last Name:HEBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1160 HOSPITAL ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760
Mailing Address - Country:US
Mailing Address - Phone:225-638-4455
Mailing Address - Fax:225-208-6173
Practice Address - Street 1:1160 HOSPITAL ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760
Practice Address - Country:US
Practice Address - Phone:225-638-4455
Practice Address - Fax:225-208-6173
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07135174400000X
LA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist