MEDICARE: MS. CHIANTAY O'CONNER 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	2355S0801X	Speech-Language Assistant	8344	LA
2	235Z00000X	Speech-Language Pathologist	8344	LA

General Provider Information

NPI Number	:	1891390191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHIANTAY O'CONNER SLP

Provider Business Mailing Address
First Line	:	9673 GRAND TETON AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70814-4014
Country	:	US
Telephone Number	:	225-456-4616
Fax Number	:

Provider Business Practice Location Address
First Line	:	9673 GRAND TETON AVE
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70814-4014
Country	:	US
Telephone Number	:	225-456-4616
Fax Number	:

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

Provider Enumeration Date	:	12/03/2020
Last Update Date	:	08/31/2025

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