Provider Demographics
NPI:1487548863
Name:LAFLEUR, MADELINE GRACE (OTR/L)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:GRACE
Last Name:LAFLEUR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 RICE RD APT 809
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-1091
Mailing Address - Country:US
Mailing Address - Phone:601-213-7398
Mailing Address - Fax:
Practice Address - Street 1:501 E NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-3604
Practice Address - Country:US
Practice Address - Phone:601-924-0645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4193225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist