Provider Demographics
NPI:1215415393
Name:MAJLESEIN, PARISSA L (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:PARISSA
Middle Name:L
Last Name:MAJLESEIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39238 MAJESTIC WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-6556
Mailing Address - Country:US
Mailing Address - Phone:225-241-4996
Mailing Address - Fax:
Practice Address - Street 1:39238 MAJESTIC WOOD AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-6556
Practice Address - Country:US
Practice Address - Phone:225-241-4996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist