Provider Demographics
NPI:1376633354
Name:MILLET, LEANNE LOUQUE (LOTR)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:LOUQUE
Last Name:MILLET
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:PO BOX 2965
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-2965
Mailing Address - Country:US
Mailing Address - Phone:985-542-7878
Mailing Address - Fax:985-542-7878
Practice Address - Street 1:2204 ROBIN AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5751
Practice Address - Country:US
Practice Address - Phone:985-542-7878
Practice Address - Fax:985-542-4396
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTZ12391225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA8291494OtherAETNA
LA1677485Medicaid
LA640001OtherUNITED HEALTHCARE
LA640001OtherUNITED HEALTHCARE
LAOTZ12391Medicare UPIN