Provider Demographics
NPI:1013800531
Name:MEDICA, MIKAELA LYNN (MOT)
Entity type:Individual
Prefix:
First Name:MIKAELA
Middle Name:LYNN
Last Name:MEDICA
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10730 CLASSIQUE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4891
Mailing Address - Country:US
Mailing Address - Phone:225-456-4800
Mailing Address - Fax:
Practice Address - Street 1:9063 SIEGEN LN STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2051
Practice Address - Country:US
Practice Address - Phone:225-294-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics