Provider Demographics
NPI:1831424274
Name:CRISLER, HESTER CC (LOTR)
Entity type:Individual
Prefix:
First Name:HESTER
Middle Name:CC
Last Name:CRISLER
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 1:7358 EASTLAKE RD
Mailing Address - Street 2:
Mailing Address - City:STERLINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:71280-3214
Mailing Address - Country:US
Mailing Address - Phone:318-614-4952
Mailing Address - Fax:318-388-8558
Practice Address - Street 1:803 STUBBS AVE STE D
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5581
Practice Address - Country:US
Practice Address - Phone:318-388-8414
Practice Address - Fax:318-388-8558
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.200332225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAOTT.200332OtherLA STATE BOARD OF EXAMINERS