Basic Information
| Provider Information | |||||||||
| NPI: | 1104335009 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CHESHIER | ||||||||
| FirstName: | ABBIGAIL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4109 HIGHWAY 98 W | ||||||||
| Address2: | |||||||||
| City: | SUMMIT | ||||||||
| State: | MS | ||||||||
| PostalCode: | 396669132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6012763909 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1175 PINE ST | ||||||||
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| City: | ARCADIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 710013121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6012763909 | ||||||||
| FaxNumber: | 6012763909 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2017 | ||||||||
| LastUpdateDate: | 09/22/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 301916 | LA | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.