Healthcare Provider Details

I. General information

NPI: 1851222467
Provider Name (Legal Business Name): BAILEY WEBER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E 25TH AVE
COVINGTON LA
70433-2820
US

IV. Provider business mailing address

802 UNIVERSITY CT
MANDEVILLE LA
70448-1007
US

V. Phone/Fax

Practice location:
  • Phone: 985-327-5352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10084
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: