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NPI Code Detail

MEDICARE: SHANNON FRUGE M.C.D., CCC-SLP

MEDICARE: SHANNON FRUGE M.C.D., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist3290LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336275262
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON FRUGE M.C.D., CCC-SLP
Provider Business Mailing Address
First Line : 4600 RIVER RD
Second Line :
City : MARRERO
State : LA
Zip : 70072-1943
Country : US
Telephone Number : 337-654-7404
Fax Number :
Provider Business Practice Location Address
First Line : 4600 RIVER RD
Second Line :
City : MARRERO
State : LA
Zip : 70072-1943
Country : US
Telephone Number : 337-654-7404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 01/10/2022

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Directions to “ SHANNON FRUGE M.C.D., CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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