Provider Demographics
NPI:1891813051
Name:TRAHAN, ROBERT (LOTR)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12338 NORTHWOOD XING
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-6014
Mailing Address - Country:US
Mailing Address - Phone:985-969-5039
Mailing Address - Fax:833-644-0884
Practice Address - Street 1:12338 NORTHWOOD XING
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-6014
Practice Address - Country:US
Practice Address - Phone:985-969-5039
Practice Address - Fax:985-902-8587
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z11771225X00000X, 225XL0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist