Provider Demographics
NPI:1528027604
Name:CHILDREN'S SPEECH, LANGUAGE, AND HEARING CENTER, INC.
Entity Type:Organization
Organization Name:CHILDREN'S SPEECH, LANGUAGE, AND HEARING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR,SLP
Authorized Official - Prefix:MR
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:G
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:985-290-8999
Mailing Address - Street 1:1361 CORPORATE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3147
Mailing Address - Country:US
Mailing Address - Phone:985-290-8999
Mailing Address - Fax:
Practice Address - Street 1:1361 CORPORATE SQUARE DR
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-3147
Practice Address - Country:US
Practice Address - Phone:985-290-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty