Provider Demographics
NPI:1689455842
Name:LANDRY, MEGHAN (SLP ASSISTANT)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:LANDRY
Suffix:
Gender:F
Credentials:SLP ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13909 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-6340
Mailing Address - Country:US
Mailing Address - Phone:225-686-4335
Mailing Address - Fax:225-686-4335
Practice Address - Street 1:13909 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754-6340
Practice Address - Country:US
Practice Address - Phone:225-686-4335
Practice Address - Fax:225-686-4335
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9243235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist