Provider Demographics
NPI:1629096466
Name:GAUTHIER, CATHY CHAPMAN (OT)
Entity type:Individual
Prefix:PROF
First Name:CATHY
Middle Name:CHAPMAN
Last Name:GAUTHIER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 OLD JEANERETTE RD
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-5800
Mailing Address - Country:US
Mailing Address - Phone:337-367-3331
Mailing Address - Fax:367-367-6494
Practice Address - Street 1:1307 OLD JEANERETTE RD
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-5800
Practice Address - Country:US
Practice Address - Phone:337-367-3331
Practice Address - Fax:367-367-6494
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ10815225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAOTT.Z10815OtherOT LA LICENSE