Provider Demographics
NPI:1437914884
Name:PAYNE, ISABELLA (MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17732 HIGHLAND RD, STE G, BOX 243
Mailing Address - Street 2:NA
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810
Mailing Address - Country:US
Mailing Address - Phone:225-292-4138
Mailing Address - Fax:225-636-2940
Practice Address - Street 1:18268 PETROLEUM DR # NA
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-6126
Practice Address - Country:US
Practice Address - Phone:225-292-4138
Practice Address - Fax:225-636-2940
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA340212225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics