Provider Demographics
NPI:1609209360
Name:ELDRIDGE, KRISTIN DAVIS (LOTR)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:DAVIS
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:JADE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:3631 WESTERVELT AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-5056
Mailing Address - Country:US
Mailing Address - Phone:337-412-4126
Mailing Address - Fax:
Practice Address - Street 1:3631 WESTERVELT AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-5056
Practice Address - Country:US
Practice Address - Phone:337-412-4126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200637225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics