Provider Demographics
NPI:1326231671
Name:DUNCAN, MONIQUE MARIE (MOT)
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MARIE
Last Name:DUNCAN
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 1:4400 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:A #298
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6760
Mailing Address - Country:US
Mailing Address - Phone:337-298-4709
Mailing Address - Fax:337-439-3380
Practice Address - Street 1:3221 RYAN ST
Practice Address - Street 2:SUITE D
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8780
Practice Address - Country:US
Practice Address - Phone:337-439-3344
Practice Address - Fax:337-439-3380
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTTZ12050225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist