MEDICARE: CYPRESS SPEECH & SWALLOWING SPECIALISTS, LLC

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

General Provider Information

NPI Number	:	1417649179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYPRESS SPEECH & SWALLOWING SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	128 TEMECULA DR
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71292-0476
Country	:	US
Telephone Number	:	318-348-7365
Fax Number	:

Provider Business Practice Location Address
First Line	:	1326 HIGHWAY 80 E
Second Line	:
City	:	CALHOUN
State	:	LA
Zip	:	71225-9113
Country	:	US
Telephone Number	:	318-599-1391
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST/OWNER
Name	:	LEZLEE SHAUF
Credential	:	M.S., CCC-SLP
Telephone Number	:	318-348-7365

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	05/22/2023

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