Provider Demographics
NPI:1649040189
Name:HARBOURT, ROBIN (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:HARBOURT
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 LONDONDERRY SQ
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6443
Mailing Address - Country:US
Mailing Address - Phone:337-789-7070
Mailing Address - Fax:
Practice Address - Street 1:705 S MORGAN AVE STE A
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-4951
Practice Address - Country:US
Practice Address - Phone:337-252-7449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00671225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist