Provider Demographics
NPI:1639780109
Name:MCDANIEL, CIERRA (L/CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:L/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29977 OWENS CIR
Mailing Address - Street 2:
Mailing Address - City:HOLDEN
Mailing Address - State:LA
Mailing Address - Zip Code:70744-4501
Mailing Address - Country:US
Mailing Address - Phone:985-514-0129
Mailing Address - Fax:
Practice Address - Street 1:24495 LA HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-6421
Practice Address - Country:US
Practice Address - Phone:225-665-5815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist