Provider Demographics
NPI:1639305626
Name:BUFORD, MARGIE Z (LOTR)
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:Z
Last Name:BUFORD
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 1:174 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8592
Mailing Address - Country:US
Mailing Address - Phone:318-267-1381
Mailing Address - Fax:
Practice Address - Street 1:174 PRESTON RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8592
Practice Address - Country:US
Practice Address - Phone:318-267-1381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200282225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist