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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

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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.