Provider Demographics
NPI:1649530916
Name:SONNIER, MELISSA ORTEGO (PT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ORTEGO
Last Name:SONNIER
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 RUE LOUIS XIV
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5739
Mailing Address - Country:US
Mailing Address - Phone:337-889-3106
Mailing Address - Fax:
Practice Address - Street 1:6331 CAMERON ST STE 102
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:LA
Practice Address - Zip Code:70583-5021
Practice Address - Country:US
Practice Address - Phone:337-889-3106
Practice Address - Fax:337-504-7453
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08310225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3D223-CD63OtherPTAN