Provider Demographics
NPI:1114151701
Name:DUPUY, MICHELLE LEIGH (PT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LEIGH
Last Name:DUPUY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25886 STONEHENGE DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6097
Mailing Address - Country:US
Mailing Address - Phone:225-243-7893
Mailing Address - Fax:
Practice Address - Street 1:25886 STONEHENGE DR
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-6097
Practice Address - Country:US
Practice Address - Phone:225-243-7893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist