MEDICARE: ANALICIA NOLAN M.A. 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
1	235Z00000X	Speech-Language Pathologist	7422	LA

General Provider Information

NPI Number	:	1710361043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANALICIA NOLAN M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	14642 JAMESTOWN BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-3485
Country	:	US
Telephone Number	:	504-655-1653
Fax Number	:

Provider Business Practice Location Address
First Line	:	14642 JAMESTOWN BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-3485
Country	:	US
Telephone Number	:	504-655-1653
Fax Number	:

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

Provider Enumeration Date	:	07/16/2015
Last Update Date	:	02/11/2026

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