MEDICARE: JENI CAROLINE FRICK GUERICA M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	8113	LA

General Provider Information

NPI Number	:	1245801240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENI CAROLINE FRICK GUERICA M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2135 SHADOWBROOK DR W
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-2969
Country	:	US
Telephone Number	:	225-937-7275
Fax Number	:

Provider Business Practice Location Address
First Line	:	4703 BLUEBONNET BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-9635
Country	:	US
Telephone Number	:	225-291-2221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2021
Last Update Date	:	07/09/2021

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