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NPI Code Detail

MEDICARE: NATALIE H OVERALL

MEDICARE:   NATALIE H OVERALL
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 Pathologist5572LA

General Provider Information

NPI Number : 1487736773
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE H OVERALL
Provider Business Mailing Address
First Line : 16028 SHENANDOAH AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70817-3651
Country : US
Telephone Number : 225-752-5142
Fax Number :
Provider Business Practice Location Address
First Line : 768 CHEVELLE DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-6503
Country : US
Telephone Number : 225-930-0208
Fax Number : 225-930-0221
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2006
Last Update Date : 07/08/2007

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Directions to “ NATALIE H OVERALL ” Practice Location

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