Provider Demographics
NPI:1952149510
Name:DECOTEAU, BAILEY YARBROUGH (OTR/L)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:YARBROUGH
Last Name:DECOTEAU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16006 KNOLL CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-1671
Mailing Address - Country:US
Mailing Address - Phone:225-402-9408
Mailing Address - Fax:
Practice Address - Street 1:6605 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8104
Practice Address - Country:US
Practice Address - Phone:225-767-5032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA342140225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics