Provider Demographics
NPI:1154948701
Name:BRIGNAC, AMANDA (MOT LOTR)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BRIGNAC
Suffix:
Gender:F
Credentials:MOT LOTR
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:HINKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT LOTR
Mailing Address - Street 1:3329 METAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5215
Mailing Address - Country:US
Mailing Address - Phone:504-565-7300
Mailing Address - Fax:504-565-7329
Practice Address - Street 1:3329 METAIRIE RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5215
Practice Address - Country:US
Practice Address - Phone:504-565-7300
Practice Address - Fax:504-565-7329
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist