Healthcare Provider Details

I. General information

NPI: 1538001003
Provider Name (Legal Business Name): REAGHAN DOIRON MILLER SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E. KENTUCKY AVE
RUSTON LA
71270
US

IV. Provider business mailing address

1701 OLD MINDEN RD STE 21
BOSSIER CITY LA
71111-4846
US

V. Phone/Fax

Practice location:
  • Phone: 318-408-1664
  • Fax: 318-588-7813
Mailing address:
  • Phone: 318-789-7239
  • Fax: 318-588-7813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number9304
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: