Provider Demographics
NPI:1295380806
Name:NORRIS, LAREAN (LPTA)
Entity Type:Individual
Prefix:
First Name:LAREAN
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WHITNEY AVE APT 341
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-3343
Mailing Address - Country:US
Mailing Address - Phone:504-875-5073
Mailing Address - Fax:
Practice Address - Street 1:2700 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-3310
Practice Address - Country:US
Practice Address - Phone:504-875-5073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA5084225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant