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NPI Code Detail

MEDICARE: MS. AMY E FORREST M.S., CCC-SLP

MEDICARE: MS. AMY E FORREST M.S., 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
1235Z00000XSpeech-Language Pathologist5729LA

General Provider Information

NPI Number : 1922235969
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY E FORREST M.S., CCC-SLP
Provider Business Mailing Address
First Line : 605 SILVERTHORNE LN
Second Line :
City : COVINGTON
State : LA
Zip : 70433-7823
Country : US
Telephone Number : 985-320-5906
Fax Number :
Provider Business Practice Location Address
First Line : 132 S 6TH ST
Second Line :
City : PONCHATOULA
State : LA
Zip : 70454-3317
Country : US
Telephone Number : 985-386-6884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2009
Last Update Date : 08/21/2012

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