Most Relevant Information
Provider Data
| NPI Number: | 1003284225 |
| Provider Name: | DANIELLE NESTER FAULK MOT |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/03/2015 |
| Last Updated: | 06/09/2017 |
Provider Practice Location
208 W MCNEESE ST
LAKE CHARLES
LA
706055638
Practice Location Phone/Fax
| Phone: | 3374751053 |
| Fax: | 3374751048 |
Provider Mailing Location
208 W MCNEESE ST
LAKE CHARLES
LA
706055638
Provider Mailing Phone/Fax
| Phone: | 3374751053 |
| Fax: | 3374751048 |