MEDICARE: TABITHA FRANCES DALGO MCD, 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	8905	LA

General Provider Information

NPI Number	:	1972320836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TABITHA FRANCES DALGO MCD, CCC-SLP

Provider Business Mailing Address
First Line	:	731 AVENUE E
Second Line	:
City	:	WESTWEGO
State	:	LA
Zip	:	70094-4406
Country	:	US
Telephone Number	:	504-905-0756
Fax Number	:

Provider Business Practice Location Address
First Line	:	3339 BELFORT AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-2819
Country	:	US
Telephone Number	:	504-905-0756
Fax Number	:

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

Provider Enumeration Date	:	09/23/2024
Last Update Date	:	09/23/2024

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