Provider Demographics
NPI:1417724618
Name:MIDDLETON, DELLA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DELLA
Middle Name:
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1956 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:LA
Mailing Address - Zip Code:71001-3524
Mailing Address - Country:US
Mailing Address - Phone:318-263-9416
Mailing Address - Fax:
Practice Address - Street 1:1956 1ST ST
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:LA
Practice Address - Zip Code:71001-3524
Practice Address - Country:US
Practice Address - Phone:318-263-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5772235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist