Provider Demographics
NPI:1598657785
Name:MOTT, TEAIRRA D
Entity type:Individual
Prefix:
First Name:TEAIRRA
Middle Name:D
Last Name:MOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 ARKANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-6407
Mailing Address - Country:US
Mailing Address - Phone:318-692-0225
Mailing Address - Fax:318-654-4081
Practice Address - Street 1:1501 ARKANSAS AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-6407
Practice Address - Country:US
Practice Address - Phone:318-692-0225
Practice Address - Fax:318-654-4081
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator