Provider Demographics
NPI:1396310322
Name:ENSMINGER, CARMEL BROWN (LOTR)
Entity type:Individual
Prefix:
First Name:CARMEL
Middle Name:BROWN
Last Name:ENSMINGER
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5834 TENNYSON DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-2931
Mailing Address - Country:US
Mailing Address - Phone:225-571-4827
Mailing Address - Fax:
Practice Address - Street 1:1050 S FOSTER DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7221
Practice Address - Country:US
Practice Address - Phone:225-922-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z10548225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist