Provider Demographics
NPI:1710932942
Name:BROWN, EMILY MANUEL (OT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:MANUEL
Last Name:BROWN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 MOOSA BLVD
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-3627
Mailing Address - Country:US
Mailing Address - Phone:337-457-8464
Mailing Address - Fax:337-546-6515
Practice Address - Street 1:441 MOOSA BLVD
Practice Address - Street 2:REHAB XCEL OF EUNICE LLC
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-3627
Practice Address - Country:US
Practice Address - Phone:337-457-8164
Practice Address - Fax:337-546-6515
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2011-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT200075225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1018767Medicaid
LA1529630Medicaid
LA3A610C892Medicare PIN