Provider Demographics
NPI:1700517174
Name:PAPE, EVA (COTA)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:PAPE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40582 E I 55 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-6408
Mailing Address - Country:US
Mailing Address - Phone:198-535-1373
Mailing Address - Fax:
Practice Address - Street 1:40582 E I 55 SERVICE RD
Practice Address - Street 2:
Practice Address - City:PONCHATOULA
Practice Address - State:LA
Practice Address - Zip Code:70454-6408
Practice Address - Country:US
Practice Address - Phone:985-351-3736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTA.200308224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant