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NPI Code Detail

MEDICARE: VIRGINIA FAITH DIETRICH MA CF-SLP

MEDICARE: VIRGINIA FAITH DIETRICH MA CF-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 Pathologist

General Provider Information

NPI Number : 1629819230
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIRGINIA FAITH DIETRICH MA CF-SLP
Provider Business Mailing Address
First Line : 4000 LAKE BEAU PRE BLVD APT 65
Second Line :
City : BATON ROUGE
State : LA
Zip : 70820-4267
Country : US
Telephone Number : 225-505-8822
Fax Number :
Provider Business Practice Location Address
First Line : 3455 BRENTWOOD DR
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-1640
Country : US
Telephone Number : 225-244-9044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2024
Last Update Date : 06/05/2024

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Directions to “ VIRGINIA FAITH DIETRICH MA CF-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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