Provider Demographics
NPI:1134763352
Name:BENOIT, ELLEN BARKEMEYER (LOTR)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:BARKEMEYER
Last Name:BENOIT
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:ELIZABETH
Other - Last Name:BARKEMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:831 LOUQUE PL
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1733
Mailing Address - Country:US
Mailing Address - Phone:504-481-9676
Mailing Address - Fax:
Practice Address - Street 1:2400 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6535
Practice Address - Country:US
Practice Address - Phone:800-935-8387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA312945225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist