Provider Demographics
NPI:1841280427
Name:ROBERSON, LUANNE ELIZABETH (LOTR, CHT)
Entity type:Individual
Prefix:MRS
First Name:LUANNE
Middle Name:ELIZABETH
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:LOTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E WORTHY ST
Mailing Address - Street 2:BUILDING IV
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-4232
Mailing Address - Country:US
Mailing Address - Phone:225-644-7044
Mailing Address - Fax:225-644-4414
Practice Address - Street 1:211 E WORTHY ST
Practice Address - Street 2:BUILDING IV
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4232
Practice Address - Country:US
Practice Address - Phone:225-644-7044
Practice Address - Fax:225-644-4414
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ10485225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA721282530ROOtherHUMANA PROVIDER #
LA2314145OtherAETNA HMO PROVIDER #
LA4320208OtherAETNA NON HMO PROVIDER #
LA721282530ROOtherHUMANA PROVIDER #