Provider Demographics
NPI:1396781084
Name:MESSINA, CATHY Z (MA/CCCA)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:Z
Last Name:MESSINA
Suffix:
Gender:F
Credentials:MA/CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7454 WASCOM LN
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739-4742
Mailing Address - Country:US
Mailing Address - Phone:225-261-0319
Mailing Address - Fax:
Practice Address - Street 1:7952 GOODWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7629
Practice Address - Country:US
Practice Address - Phone:225-927-7011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2668231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1123722Medicaid
LA4C247Medicare ID - Type Unspecified
LA1123722Medicaid