NPI 1013193879

Jennie Moore Bange, LOTR

Practitioner Occupational Therapist Shreveport, LA

Practice location

Address: 1501 Kings Hwy, Shreveport, LA 71103-4228
Phone: (318) 813-2972
Mailing address: 522 Oil Field Rd, Elm Grove, LA 71051-7909

Registered specialties

Occupational Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X Licence 200202 (LA)

Other Occupational Therapist providers in Louisiana →

Registry record

NPI: 1013193879
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Jan 2008
Record last updated: 28 Jan 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.