Healthcare Provider Details

I. General information

NPI: 1992282164
Provider Name (Legal Business Name): MEGAN CAZENAVE MCD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1876 W MAIN ST
LUTCHER LA
70071-5120
US

IV. Provider business mailing address

510 MENARD ST
THIBODAUX LA
70301-3522
US

V. Phone/Fax

Practice location:
  • Phone: 225-258-4500
  • Fax:
Mailing address:
  • Phone: 985-859-1156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number8153
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: