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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TARA EZELL WALLACE, OTA

Active

TARA EZELL WALLACE, OTA is a Occupational Therapy Assistant healthcare provider located in MONROE, Louisiana. NPI 1265319842 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapy Assistant · MONROE, LA

Registration Details

NPI Number
1265319842
Provider Type
Individual
Gender
Female
NPI Issued
Aug 18, 2025 (0.94917272129484 yrs)
Last Updated
Aug 18, 2025
License
OTA.200015 (LA)

Practice Information

Address
2301 STERLINGTON RD
MONROE, LA, 712033045
Browse LA providers · Browse ZIP 71203
Phone
3183233426
Primary Specialty
Occupational Therapy Assistant
224Z00000X

Other Occupational Therapy Assistant Providers in MONROE, LA

Name Credential NPI
JON SMILEY 1154538924
MS. PAIGE REEVES MCKOIN COTA/L 1578710729
ELIZABETH REDDING SLP 1295063964
DEREK THOMAS 1053642678
ANGELA JONES 1578859286
LINDA HENDRICKS 1922376268
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.