Provider Demographics
NPI:1033847835
Name:HARRELL, MONTERAL L (BA SLP-A 4114)
Entity Type:Individual
Prefix:MS
First Name:MONTERAL
Middle Name:L
Last Name:HARRELL
Suffix:
Gender:F
Credentials:BA SLP-A 4114
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 SW RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-6150
Mailing Address - Country:US
Mailing Address - Phone:985-748-6953
Mailing Address - Fax:
Practice Address - Street 1:301 VERNON AVE
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-2840
Practice Address - Country:US
Practice Address - Phone:985-748-6953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA41142355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant