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General NPI Number Information
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NPI Number | 1437683851
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Entity Type | Organization
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Legal Business Name | CHILDREN'S SPEECH & HEARING CLINIC, LLC
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Dates
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Enumeration Date | 04/12/2017
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 123 METAIRIE RD STE 203
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City | METAIRIE
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State | LA
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Zip | 70005-4537
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Country | US
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Telephone | 504-579-4886
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Fax |
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Provider Business Mailing Address
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Address Line | 123 METAIRIE RD STE 203
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City | METAIRIE
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State | LA
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Zip | 70005-4537
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Country | US
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Telephone | 504-579-4886
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST/OWNER
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Name | MRS. TARA C QUIN
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Credential | MCD, CCC-SLP
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Telephone | 504-579-4886
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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 | 7066
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License Number State | LA
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