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NPI Code Detail

MEDICARE: MRS. DONNA LANDRY

MEDICARE: MRS. DONNA LANDRY
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 PathologistS0950MS

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 : 1619197530
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DONNA LANDRY
Provider Business Mailing Address
First Line : 104 QUAIL CV
Second Line :
City : BRANDON
State : MS
Zip : 39047-6661
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1929 SPILLWAY RD STE A
Second Line :
City : BRANDON
State : MS
Zip : 39047-6079
Country : US
Telephone Number : 601-992-5370
Fax Number : 601-992-5370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2007
Last Update Date : 07/09/2007

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Directions to “ MRS. DONNA LANDRY ” 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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