Provider Demographics
NPI:1285292870
Name:STRONG, DARICA (PTA)
Entity type:Individual
Prefix:
First Name:DARICA
Middle Name:
Last Name:STRONG
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 H SMITH RD
Mailing Address - Street 2:
Mailing Address - City:BATCHELOR
Mailing Address - State:LA
Mailing Address - Zip Code:70715-3310
Mailing Address - Country:US
Mailing Address - Phone:318-359-2326
Mailing Address - Fax:225-638-3261
Practice Address - Street 1:1820 FALSE RIVER DR
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2606
Practice Address - Country:US
Practice Address - Phone:225-638-4431
Practice Address - Fax:225-638-3261
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA7198225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant