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NPI Code Detail

MEDICARE: LAILA QUDSI CCC-SLP

MEDICARE:   LAILA  QUDSI  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 PathologistSLP008004GA

General Provider Information

NPI Number : 1427300383
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAILA QUDSI CCC-SLP
Provider Business Mailing Address
First Line : 3402 INVERNESS PKWY
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-1923
Country : US
Telephone Number : 706-326-7522
Fax Number :
Provider Business Practice Location Address
First Line : 705 17TH ST
Second Line : SUITE 407
City : COLUMBUS
State : GA
Zip : 31901-3500
Country : US
Telephone Number : 706-321-0930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2012
Last Update Date : 10/02/2012

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Directions to “ LAILA QUDSI CCC-SLP” Practice Location

Language Start Address Practice Location
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