Provider Demographics
NPI:1811149339
Name:FOREMAN, MARY F
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:F
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RED CROSS PL
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3732
Mailing Address - Country:US
Mailing Address - Phone:985-516-6892
Mailing Address - Fax:
Practice Address - Street 1:100 RED CROSS PL
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3732
Practice Address - Country:US
Practice Address - Phone:985-516-6892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3100231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3100OtherSPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY