Provider Demographics
NPI:1750650164
Name:KINNARD, KAREY K (LOTR, MOT)
Entity Type:Individual
Prefix:MRS
First Name:KAREY
Middle Name:K
Last Name:KINNARD
Suffix:
Gender:F
Credentials:LOTR, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 HERMITAGE LOOP
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-8371
Mailing Address - Country:US
Mailing Address - Phone:985-856-7976
Mailing Address - Fax:
Practice Address - Street 1:7927 PARK AVE
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-3286
Practice Address - Country:US
Practice Address - Phone:985-580-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z12190225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist