Provider Demographics
NPI:1275261612
Name:HECKER, RAELYNN LAMBERT (PT, DPT)
Entity type:Individual
Prefix:
First Name:RAELYNN
Middle Name:LAMBERT
Last Name:HECKER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:RAELYNN
Other - Middle Name:MARIE
Other - Last Name:LAMBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1729 DEROCHE CIR
Mailing Address - Street 2:
Mailing Address - City:GRAMERCY
Mailing Address - State:LA
Mailing Address - Zip Code:70052-3557
Mailing Address - Country:US
Mailing Address - Phone:225-258-9480
Mailing Address - Fax:225-258-9482
Practice Address - Street 1:1729 DEROCHE CIR
Practice Address - Street 2:
Practice Address - City:GRAMERCY
Practice Address - State:LA
Practice Address - Zip Code:70052-3557
Practice Address - Country:US
Practice Address - Phone:225-258-9480
Practice Address - Fax:225-258-9482
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112342251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic