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Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Organization
LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
Mollie E Webb Speech & Hearing Center, Allied Health Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
REVA MATTHIEW ROBINSON MBA (DIRECTOR OF CLIN MGMT SYSTEM)
(318) 813-2962
Entity
Organization
Contact information
Practice address
3735 BLAIR DR, SHREVEPORT, LA 71103-4601
(318) 813-2962
(318) 813-2981
Mailing address
1501 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 813-2962
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
LA
332S00000X
Hearing Aid Equipment
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174173
—
LA
Enumeration date
02/08/2007
Last updated
07/31/2020
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