Provider Demographics
NPI:1386499879
Name:SIBLEY, ALLISON D (OT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:D
Last Name:SIBLEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:D
Other - Last Name:GAGNARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:245 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-2103
Mailing Address - Country:US
Mailing Address - Phone:337-298-1810
Mailing Address - Fax:
Practice Address - Street 1:245 3RD ST
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-2103
Practice Address - Country:US
Practice Address - Phone:337-298-1810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA301786225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics