Provider Demographics
NPI:1851806277
Name:SEGURA-LEVY, CAROLYN SUZANNE (OT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:SUZANNE
Last Name:SEGURA-LEVY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:SUZANNE
Other - Last Name:SEGURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:6565 LOUIS XIV ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8128 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7865
Practice Address - Country:US
Practice Address - Phone:225-791-8666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z12199225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist