Provider Demographics
NPI:1073844064
Name:POINTER, ROSE G (MED CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:G
Last Name:POINTER
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11140 N HARRELLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-8307
Mailing Address - Country:US
Mailing Address - Phone:225-926-1838
Mailing Address - Fax:225-275-0930
Practice Address - Street 1:11140 N HARRELLS FERRY RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8307
Practice Address - Country:US
Practice Address - Phone:225-926-1838
Practice Address - Fax:225-275-0930
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3981235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist