Provider Demographics
NPI:1285190801
Name:BOHTE, MADISON RALPH (LOTR)
Entity Type:Individual
Prefix:MRS
First Name:MADISON
Middle Name:RALPH
Last Name:BOHTE
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 1:4213 LUCERNE ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2443
Mailing Address - Country:US
Mailing Address - Phone:251-786-0247
Mailing Address - Fax:
Practice Address - Street 1:3013 27TH ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6013
Practice Address - Country:US
Practice Address - Phone:504-291-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics