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General NPI Number Information
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NPI Number | 1053055913
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Entity Type | Individual
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Provider Name | KELSEY POCHE ABBAS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 1956 1ST ST
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City | ARCADIA
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State | LA
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Zip | 71001-3524
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Country | US
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Telephone | 318-236-9416
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Fax |
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Provider Business Mailing Address
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Address Line | 9303 SHENANDOAH CIR
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City | SHREVEPORT
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State | LA
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Zip | 71115-3743
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Country | US
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Telephone | 480-236-9882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7134
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License Number State | LA
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