Provider Demographics
NPI:1659323129
Name:DELAHOUSSAYE, SCOTT W (PT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:W
Last Name:DELAHOUSSAYE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WOODLAND HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1674
Mailing Address - Country:US
Mailing Address - Phone:504-392-7000
Mailing Address - Fax:504-584-7747
Practice Address - Street 1:102 WOODLAND HWY STE 1
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-1674
Practice Address - Country:US
Practice Address - Phone:504-392-7000
Practice Address - Fax:504-584-7747
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA04695OtherLA PT LICENSE #
LA4B788C566Medicare ID - Type UnspecifiedMC PROVIDER #