Provider Demographics
NPI:1811397854
Name:GARCIA-GIESE, MARIA E (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:GARCIA-GIESE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6040 BELLE GROVE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-5016
Mailing Address - Country:US
Mailing Address - Phone:225-769-4648
Mailing Address - Fax:
Practice Address - Street 1:6040 BELLE GROVE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820
Practice Address - Country:US
Practice Address - Phone:225-769-4648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAL-SLP#1755235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2374184Medicaid