MEDICARE: MARGARET KORDISCH

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	4062	LA

General Provider Information

NPI Number	:	1801011028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET KORDISCH

Provider Business Mailing Address
First Line	:	142 ACACIA DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-4002
Country	:	US
Telephone Number	:	337-264-1303
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 ACACIA DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-4002
Country	:	US
Telephone Number	:	337-264-1303
Fax Number	:

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

Provider Enumeration Date	:	04/14/2007
Last Update Date	:	07/08/2007

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Directions to “ MARGARET KORDISCH ” Practice Location

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