Healthcare Provider Details

I. General information

NPI: 1174458228
Provider Name (Legal Business Name): ELIZABETH HECTOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 KALISTE SALOOM RD STE 105
LAFAYETTE LA
70508-4231
US

IV. Provider business mailing address

825 KALISTE SALOOM RD STE 105
LAFAYETTE LA
70508-4231
US

V. Phone/Fax

Practice location:
  • Phone: 337-278-3994
  • Fax: 225-366-7053
Mailing address:
  • Phone: 337-278-3994
  • Fax: 225-366-7053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10194
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: