Provider Demographics
NPI:1831062157
Name:HART, FAITH G (OTD)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:G
Last Name:HART
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:G
Other - Last Name:SIBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD
Mailing Address - Street 1:1603 GOODWIN RD
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-2907
Mailing Address - Country:US
Mailing Address - Phone:318-255-7550
Mailing Address - Fax:318-255-7552
Practice Address - Street 1:1603 GOODWIN RD
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2907
Practice Address - Country:US
Practice Address - Phone:318-255-7550
Practice Address - Fax:318-255-7552
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty