Provider Demographics
NPI:1306030994
Name:HEBERT, ALEXANDRA MARCEAUX (P T)
Entity Type:Individual
Prefix:PROF
First Name:ALEXANDRA
Middle Name:MARCEAUX
Last Name:HEBERT
Suffix:
Gender:F
Credentials:P T
Other - Prefix:PROF
Other - First Name:ALEXANDRA
Other - Middle Name:LEE
Other - Last Name:MARCEAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:P T
Mailing Address - Street 1:317 ODEA ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-4052
Mailing Address - Country:US
Mailing Address - Phone:337-893-3258
Mailing Address - Fax:337-898-0495
Practice Address - Street 1:317 ODEA ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4052
Practice Address - Country:US
Practice Address - Phone:337-893-3258
Practice Address - Fax:337-898-0495
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA03666225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist