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NPI Code Detail

MEDICARE: EXCELLENCE IN SPEECH PATHOLOGY LLC

MEDICARE: EXCELLENCE IN SPEECH PATHOLOGY 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
1252Y00000XEarly Intervention Provider Agency3486LA

General Provider Information

NPI Number : 1689819963
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCELLENCE IN SPEECH PATHOLOGY LLC
Provider Business Mailing Address
First Line : 6658 MILLSTONE AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-5114
Country : US
Telephone Number : 225-767-6831
Fax Number :
Provider Business Practice Location Address
First Line : 6658 MILLSTONE AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70808-5114
Country : US
Telephone Number : 225-767-6831
Fax Number :
Authorized Official
Title or Position : SPEECH LANGUAGE PATHOLOGIST
Name : MRS. JOY JOHNSON PENNINGTON
Credential :
Telephone Number : 225-767-6831
Provider Enumeration Date : 12/15/2008
Last Update Date : 12/15/2008

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Directions to “EXCELLENCE IN SPEECH PATHOLOGY LLC ” 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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