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NPI Code Detail

MEDICARE: BONNIE MARTIN MCD, CCC-SLP

MEDICARE: BONNIE MARTIN MCD, 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
1235Z00000XSpeech-Language Pathologist2575LA

General Provider Information

NPI Number : 1285163428
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONNIE MARTIN MCD, CCC-SLP
Provider Business Mailing Address
First Line : 3251 RIVER OAKS DR
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70131-7011
Country : US
Telephone Number : 504-421-1907
Fax Number :
Provider Business Practice Location Address
First Line : 3251 RIVER OAKS DR
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70131-7011
Country : US
Telephone Number : 504-421-1907
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2017
Last Update Date : 07/21/2022

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Directions to “ BONNIE MARTIN MCD, CCC-SLP” Practice Location

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