Healthcare Provider Details

I. General information

NPI: 1093229460
Provider Name (Legal Business Name): ASA PAUL WARREN ,M.S., CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4044 BIENVILLE RD STE A
RINGGOLD LA
71068-3293
US

IV. Provider business mailing address

3260 FRANKLIN RD
HEFLIN LA
71039-3304
US

V. Phone/Fax

Practice location:
  • Phone: 318-894-2911
  • Fax:
Mailing address:
  • Phone: 318-455-8227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7589
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: