MEDICARE: MS. SUZANNAH EDGAR M.A.

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	7454	LA

General Provider Information

NPI Number	:	1508004326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUZANNAH EDGAR M.A.

Provider Business Mailing Address
First Line	:	6550 SEVENOAKS AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-7324
Country	:	US
Telephone Number	:	252-929-8600
Fax Number	:	812-333-6641

Provider Business Practice Location Address
First Line	:	9765 CUYHANGA PKWY
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70815-1308
Country	:	US
Telephone Number	:	252-960-2402
Fax Number	:

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

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	01/03/2022

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Directions to “ MS. SUZANNAH EDGAR M.A.” Practice Location

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