Provider Demographics
NPI:1255567822
Name:TRAHAN, PAULA ANN (PTA)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ANN
Last Name:TRAHAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3904 COTEAU RD
Mailing Address - Street 2:LOT A
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-7661
Mailing Address - Country:US
Mailing Address - Phone:337-349-2918
Mailing Address - Fax:
Practice Address - Street 1:3904 COTEAU RD
Practice Address - Street 2:LOT A
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-7661
Practice Address - Country:US
Practice Address - Phone:337-349-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA7184225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant