Provider Demographics
NPI:1134208325
Name:LEBOEUF, ROBIN LYNN (COTA)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNN
Last Name:LEBOEUF
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4432 WARD RD
Mailing Address - Street 2:
Mailing Address - City:KAPLAN
Mailing Address - State:LA
Mailing Address - Zip Code:70548-6240
Mailing Address - Country:US
Mailing Address - Phone:337-788-3811
Mailing Address - Fax:
Practice Address - Street 1:220 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-5906
Practice Address - Country:US
Practice Address - Phone:337-893-2899
Practice Address - Fax:337-898-5816
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ20659224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant