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NPI Code Detail

MEDICARE: MRS. JACQUELINE SHILO-GRADNIGO M.ED., CCC-SLP

MEDICARE: MRS. JACQUELINE SHILO-GRADNIGO M.ED., 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 Pathologist3792LA

General Provider Information

NPI Number : 1346243854
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACQUELINE SHILO-GRADNIGO M.ED., CCC-SLP
Provider Business Mailing Address
First Line : 971 HIGHWAY 167
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-1227
Country : US
Telephone Number : 337-826-0777
Fax Number :
Provider Business Practice Location Address
First Line : 971 HIGHWAY 167
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-1227
Country : US
Telephone Number : 337-826-0777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. JACQUELINE SHILO-GRADNIGO M.ED., CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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