Provider Demographics
NPI:1285624783
Name:DOUGLAS, AREWANDA W (LOTR CHT)
Entity type:Individual
Prefix:MS
First Name:AREWANDA
Middle Name:W
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:LOTR CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7855 HOWELL BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70807
Mailing Address - Country:US
Mailing Address - Phone:225-454-6005
Mailing Address - Fax:225-454-6018
Practice Address - Street 1:7855 HOWELL BLVD
Practice Address - Street 2:STE 220
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70807
Practice Address - Country:US
Practice Address - Phone:225-454-6005
Practice Address - Fax:225-454-6018
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALZ10276225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand