Provider Demographics
NPI:1245218122
Name:MECHE, SCOTT JAMES (OT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:JAMES
Last Name:MECHE
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 FIR ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-8122
Mailing Address - Country:US
Mailing Address - Phone:337-794-1053
Mailing Address - Fax:
Practice Address - Street 1:3608 KIRKMAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-3006
Practice Address - Country:US
Practice Address - Phone:337-794-1053
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ11745225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H549CR28Medicare ID - Type Unspecified