Provider Demographics
NPI:1437683851
Name:CHILDREN'S SPEECH & HEARING CLINIC, LLC
Entity Type:Organization
Organization Name:CHILDREN'S SPEECH & HEARING CLINIC, LLC
Other - Org Name:CHILDREN'S SPEECH & HEARING CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH PATHOLOGIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:QUIN
Authorized Official - Suffix:
Authorized Official - Credentials:MCD, CCC-SLP
Authorized Official - Phone:504-579-4886
Mailing Address - Street 1:123 METAIRIE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4537
Mailing Address - Country:US
Mailing Address - Phone:504-579-4886
Mailing Address - Fax:
Practice Address - Street 1:123 METAIRIE RD STE 203
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4537
Practice Address - Country:US
Practice Address - Phone:504-579-4886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty