Provider Demographics
NPI:1326376286
Name:DUPLESSIS, INA RENE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:INA
Middle Name:RENE
Last Name:DUPLESSIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1583 E SECOND ST
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-3125
Mailing Address - Country:US
Mailing Address - Phone:228-452-3260
Mailing Address - Fax:228-452-3260
Practice Address - Street 1:1583 E SECOND ST
Practice Address - Street 2:
Practice Address - City:PASS CHRISTIAN
Practice Address - State:MS
Practice Address - Zip Code:39571-3125
Practice Address - Country:US
Practice Address - Phone:228-452-3260
Practice Address - Fax:228-452-3260
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT 0990172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker