Provider Demographics
NPI:1457769093
Name:CAVETT, LOU ANN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LOU ANN
Middle Name:
Last Name:CAVETT
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 1:518 CARLISLE CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7388
Mailing Address - Country:US
Mailing Address - Phone:601-573-7423
Mailing Address - Fax:
Practice Address - Street 1:518 CARLISLE CIR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-7388
Practice Address - Country:US
Practice Address - Phone:601-573-7423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT1430225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist