Provider Demographics
NPI:1801158357
Name:FRENCH, MINDY LEIGH (MCD CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MINDY
Middle Name:LEIGH
Last Name:FRENCH
Suffix:
Gender:F
Credentials:MCD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTAGEVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63873-1036
Mailing Address - Country:US
Mailing Address - Phone:573-931-3302
Mailing Address - Fax:
Practice Address - Street 1:100 W 12TH ST
Practice Address - Street 2:
Practice Address - City:PORTAGEVILLE
Practice Address - State:MO
Practice Address - Zip Code:63873-1036
Practice Address - Country:US
Practice Address - Phone:573-931-3302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011010012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist