Provider Demographics
NPI:1457500175
Name:CHAUVIN, MICHEL LEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MICHEL
Middle Name:LEE
Last Name:CHAUVIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 HIGHLAND TRACE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-5059
Mailing Address - Country:US
Mailing Address - Phone:310-428-6424
Mailing Address - Fax:
Practice Address - Street 1:5329 DIJON DR STE 103
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4378
Practice Address - Country:US
Practice Address - Phone:310-428-6424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT10196174400000X
LA334250225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No174400000XOther Service ProvidersSpecialist