Provider Demographics
NPI:1891081683
Name:MACDONALD, JAMIE L (OTR)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:L
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:4111 FAIRMONT DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-4823
Mailing Address - Country:US
Mailing Address - Phone:504-232-1210
Mailing Address - Fax:
Practice Address - Street 1:501 MANHATTAN BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-4443
Practice Address - Country:US
Practice Address - Phone:504-349-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 14684225XN1300X, 225XP0019X, 225XP0200X
LAOTT.200395225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation