Provider Demographics
NPI:1619309903
Name:AUCOIN, TERESA HARPER (LOTR)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:HARPER
Last Name:AUCOIN
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 1:129 OAKRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3219
Mailing Address - Country:US
Mailing Address - Phone:337-237-3395
Mailing Address - Fax:
Practice Address - Street 1:129 OAKRIDGE ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-3219
Practice Address - Country:US
Practice Address - Phone:337-237-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ10226225X00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist