Healthcare Provider Details

I. General information

NPI: 1245319433
Provider Name (Legal Business Name): TRISHA DEGETAIRE FRITH M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 S JEFFERSON ST
ABBEVILLE LA
70510-5906
US

IV. Provider business mailing address

20619 MAHOGANY RD
KAPLAN LA
70548-6354
US

V. Phone/Fax

Practice location:
  • Phone: 337-893-2899
  • Fax:
Mailing address:
  • Phone: 337-643-8114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3125
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: