Provider Demographics
NPI:1902524507
Name:LACHNEY, COURTNEY BLAIRE (LOTR)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BLAIRE
Last Name:LACHNEY
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:BLAIRE
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1450 GREGG AVE
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-5802
Mailing Address - Country:US
Mailing Address - Phone:337-466-6778
Mailing Address - Fax:
Practice Address - Street 1:108 ENERGY PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3818
Practice Address - Country:US
Practice Address - Phone:337-504-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA328301225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA328301OtherCOMMERCIAL INSURANCE