Provider Demographics
NPI:1477289155
Name:FALTERMAN, GRACE (MOT, LOTR)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:FALTERMAN
Suffix:
Gender:F
Credentials:MOT, LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60601
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70596-0601
Mailing Address - Country:US
Mailing Address - Phone:337-501-1645
Mailing Address - Fax:
Practice Address - Street 1:501 W SAINT MARY BLVD STE 514A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-4699
Practice Address - Country:US
Practice Address - Phone:337-356-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist