Provider Demographics
NPI:1790938496
Name:MITCHELL, KAREN MANUEL (OT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MANUEL
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MANUEL
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:100 TECHE DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2538
Mailing Address - Country:US
Mailing Address - Phone:337-216-7758
Mailing Address - Fax:337-216-7787
Practice Address - Street 1:353 DOUCET RD
Practice Address - Street 2:SUITE A-2
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3444
Practice Address - Country:US
Practice Address - Phone:337-216-7758
Practice Address - Fax:337-216-7787
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ10944225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist