Provider Demographics
NPI:1518578087
Name:OLGUIN, JOCELYNE (OTR)
Entity Type:Individual
Prefix:
First Name:JOCELYNE
Middle Name:
Last Name:OLGUIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3795 WARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HORN LAKE
Mailing Address - State:MS
Mailing Address - Zip Code:38637-8303
Mailing Address - Country:US
Mailing Address - Phone:901-210-3037
Mailing Address - Fax:
Practice Address - Street 1:7784 INNOVATION PARK DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-7006
Practice Address - Country:US
Practice Address - Phone:225-343-4232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6633225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist