Provider Demographics
NPI:1811697154
Name:TRAHAN, KATHERINE ALISE (MS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ALISE
Last Name:TRAHAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1410
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-1410
Mailing Address - Country:US
Mailing Address - Phone:337-703-3270
Mailing Address - Fax:337-703-3271
Practice Address - Street 1:4212 W CONGRESS ST STE 3600
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6770
Practice Address - Country:US
Practice Address - Phone:337-703-3270
Practice Address - Fax:337-703-3271
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA311488225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist