Provider Demographics
NPI:1871155085
Name:HARPER, MARLA MICHELLE (LMT)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:MICHELLE
Last Name:HARPER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MARLA
Other - Middle Name:MICHELLE
Other - Last Name:GATLIN BEALS HARPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:9766 JEFFERSON HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2716
Mailing Address - Country:US
Mailing Address - Phone:225-726-7806
Mailing Address - Fax:
Practice Address - Street 1:9766 JEFFERSON HWY STE 101
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2716
Practice Address - Country:US
Practice Address - Phone:225-726-7806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA2163225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist