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NPI Code Detail

MEDICARE: CASSIE FONTENOT

MEDICARE: CASSIE FONTENOT
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 Pathologist7947

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730762766
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSIE FONTENOT
Provider Business Mailing Address
First Line : 8128 FLORIDA BLVD
Second Line :
City : DENHAM SPRINGS
State : LA
Zip : 70726-7865
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 954 E PRUDHOMME ST
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-8239
Country : US
Telephone Number : 337-948-3634
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2021
Last Update Date : 04/28/2021

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Directions to “ CASSIE FONTENOT ” Practice Location

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