IndividualActive
Becky Russell
NPI 1295942068 · Occupational Therapy Assistant · Mangham, LA
Provider details
- NPI number
- 1295942068
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- LA20253 (LA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
153 Brown Rd
Mangham, LA 71259-5144
Phone: (318) 791-6169
Approximate (ZIP-level) locationGet directions
Mailing address
153 Brown Rd
Mangham, LA 71259-5144
Registry dates
- Enumerated
- 2007-05-17
- Last updated
- 2020-05-21
- Certified
- 2020-05-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.