Provider Demographics
NPI:1811675937
Name:LECOQ, HEATHER DAWN (LMT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAWN
Last Name:LECOQ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3549 NW EVANGELINE TRWY STE C
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-6240
Mailing Address - Country:US
Mailing Address - Phone:337-418-2772
Mailing Address - Fax:
Practice Address - Street 1:3549 NW EVANGELINE TRWY STE C
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-6240
Practice Address - Country:US
Practice Address - Phone:337-418-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist