Healthcare Provider Details

I. General information

NPI: 1558098681
Provider Name (Legal Business Name): MELANIE TERRIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8716 SIEGEN LN
BATON ROUGE LA
70810-1944
US

IV. Provider business mailing address

23350 GENERAL GARDNER LN
ZACHARY LA
70791-6123
US

V. Phone/Fax

Practice location:
  • Phone: 225-766-8111
  • Fax:
Mailing address:
  • Phone: 225-819-7912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number10094
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: