Healthcare Provider Details

I. General information

NPI: 1851900997
Provider Name (Legal Business Name): WINN SPEECH AND HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2020
Last Update Date: 02/21/2022
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 W MAIN ST
WINNFIELD LA
71483-2717
US

IV. Provider business mailing address

204 W MAIN ST
WINNFIELD LA
71483-2717
US

V. Phone/Fax

Practice location:
  • Phone: 318-413-0873
  • Fax: 318-727-8915
Mailing address:
  • Phone: 318-413-0873
  • Fax: 318-727-8915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUDITH BRIDGES
Title or Position: OWNER/PROVIDER
Credential: CCC-SLP
Phone: 318-209-5020