MEDICARE: MEGAN SMITH MUSSO 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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1649682493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN SMITH MUSSO CCC-SLP

Provider Business Mailing Address
First Line	:	3501 5TH AVE STE A
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-2155
Country	:	US
Telephone Number	:	337-419-0086
Fax Number	:

Provider Business Practice Location Address
First Line	:	852 UNIVERSITY DR
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-6120
Country	:	US
Telephone Number	:	337-419-0086
Fax Number	:	337-415-0626

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2014
Last Update Date	:	03/22/2023

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Directions to “ MEGAN SMITH MUSSO CCC-SLP” Practice Location

Language	Start Address	Practice Location

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