Provider Demographics
NPI:1659645075
Name:THERAPEDIATRICS LLC
Entity Type:Organization
Organization Name:THERAPEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP, CIMI
Authorized Official - Phone:504-251-2189
Mailing Address - Street 1:200 SAINT ANN DR
Mailing Address - Street 2:1221
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3224
Mailing Address - Country:US
Mailing Address - Phone:504-251-2189
Mailing Address - Fax:
Practice Address - Street 1:200 SAINT ANN DR
Practice Address - Street 2:1221
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3224
Practice Address - Country:US
Practice Address - Phone:504-251-2189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty