Provider Demographics
NPI:1740311893
Name:WALKER, MICHELE SCHAETZ (PT)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:SCHAETZ
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 GIROD ST
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-5813
Mailing Address - Country:US
Mailing Address - Phone:985-674-1244
Mailing Address - Fax:985-674-1244
Practice Address - Street 1:308 GIROD ST
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-5813
Practice Address - Country:US
Practice Address - Phone:985-674-1244
Practice Address - Fax:985-674-1244
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1303593Medicaid