Provider Demographics
NPI:1417281908
Name:HEWETT, LATONYIA J (DPT)
Entity type:Individual
Prefix:
First Name:LATONYIA
Middle Name:J
Last Name:HEWETT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9511 CRESTVIEW DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70836
Mailing Address - Country:US
Mailing Address - Phone:225-224-0114
Mailing Address - Fax:888-711-0441
Practice Address - Street 1:9511 CRESTVIEW DRIVE
Practice Address - Street 2:STE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70836-3246
Practice Address - Country:US
Practice Address - Phone:225-224-0114
Practice Address - Fax:888-711-0441
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR242722225X00000X
OR6054225100000X
LA10780R225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA10780ROtherLOUISIANA PHYSICAL THERAPY BOARD