Provider Demographics
NPI:1184084410
Name:LELEUX, MELANIE
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:LELEUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 COPPER MEADOW BLVD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5531
Mailing Address - Country:US
Mailing Address - Phone:337-519-5168
Mailing Address - Fax:
Practice Address - Street 1:713 COPPER MEADOW BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5531
Practice Address - Country:US
Practice Address - Phone:337-519-5168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200301225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist