Provider Demographics
NPI:1083828321
Name:DELBUNO, TRACEY (LOTR)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:DELBUNO
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:MS
Other - First Name:TRACEY
Other - Middle Name:DALTON
Other - Last Name:DELBUNO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LOTR
Mailing Address - Street 1:209 CAWTHORN DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1523
Mailing Address - Country:US
Mailing Address - Phone:504-491-3658
Mailing Address - Fax:
Practice Address - Street 1:209 CAWTHORN DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1523
Practice Address - Country:US
Practice Address - Phone:504-491-3658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2025-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1623997Medicaid