Provider Demographics
NPI:1902030976
Name:LOUISIANA SPEECH, LANGUAGE & LEARNING CENTER, LLC
Entity Type:Organization
Organization Name:LOUISIANA SPEECH, LANGUAGE & LEARNING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLIERE-HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:225-281-4614
Mailing Address - Street 1:37093 WHITE RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3532
Mailing Address - Country:US
Mailing Address - Phone:225-281-4614
Mailing Address - Fax:225-673-8081
Practice Address - Street 1:37093 WHITE RD
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3532
Practice Address - Country:US
Practice Address - Phone:225-281-4614
Practice Address - Fax:225-673-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5247235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty