Provider Demographics
NPI:1861843708
Name:LENNARD, BRITTANY MARTIN (LOTR)
Entity Type:Individual
Prefix:MRS
First Name:BRITTANY
Middle Name:MARTIN
Last Name:LENNARD
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 JOHN PATON CIR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71119-2243
Mailing Address - Country:US
Mailing Address - Phone:318-655-5255
Mailing Address - Fax:
Practice Address - Street 1:3335 JOHN PATON CIR
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71119-2243
Practice Address - Country:US
Practice Address - Phone:318-655-5255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA324964225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist