MEDICARE: LEAH M GENUSA CALMES M.S., 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	4501	LA

General Provider Information

NPI Number	:	1942435714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH M GENUSA CALMES M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	14328 BYWOOD AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70819-2003
Country	:	US
Telephone Number	:	225-324-8201
Fax Number	:	225-274-3892

Provider Business Practice Location Address
First Line	:	14328 BYWOOD AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70819-2003
Country	:	US
Telephone Number	:	225-324-8201
Fax Number	:	225-274-3892

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

Provider Enumeration Date	:	05/22/2009
Last Update Date	:	05/22/2009

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Directions to “ LEAH M GENUSA CALMES M.S., CCC-SLP” Practice Location

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