Healthcare Provider Details

I. General information

NPI: 1912225251
Provider Name (Legal Business Name): DELTA SPEECH & LANGUAGE CONSULTANTS OF GREATER NEW ORLEANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 05/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 CAROL SUE AVE
TERRYTOWN LA
70056-5116
US

IV. Provider business mailing address

1609 CAROL SUE AVE
TERRYTOWN LA
70056-5116
US

V. Phone/Fax

Practice location:
  • Phone: 504-912-2034
  • Fax: 504-398-0943
Mailing address:
  • Phone: 504-912-2034
  • Fax: 504-398-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number5431
License Number StateLA

VIII. Authorized Official

Name: MRS. MELISSA JENNER MORRIS
Title or Position: SPEECH LANGUAGE PATHOLOGIST
Credential: MCD, L-SLP
Phone: 504-912-2034