Provider Demographics
NPI:1912339367
Name:JUNOT, BRITTNEY WALLACE (MOT, LOTR)
Entity Type:Individual
Prefix:MRS
First Name:BRITTNEY
Middle Name:WALLACE
Last Name:JUNOT
Suffix:
Gender:F
Credentials:MOT, LOTR
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:FRANCES
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, LOTR
Mailing Address - Street 1:14 S COURT VILLA DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-1721
Mailing Address - Country:US
Mailing Address - Phone:985-264-2005
Mailing Address - Fax:985-327-7253
Practice Address - Street 1:56 LOUIS PRIMA DR
Practice Address - Street 2:SUITE A
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5903
Practice Address - Country:US
Practice Address - Phone:985-327-7256
Practice Address - Fax:985-327-7253
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200651225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist