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Organization
JETER SPEECH LANGUAGE PATHOLOGY SERVICES, LLC
Active
Organization
JETER SPEECH LANGUAGE PATHOLOGY SERVICES, LLC
Active
Other names
Jeter Therapy Group
Organization subpart
No
Provider details
NPI number
Authorized official
DANA RENE WILLIAMS MCD/CCC-SLP (OWNER)
(337) 718-3404
Entity
Organization
Contact information
Practice address
1950 E 70TH ST STE A, SHREVEPORT, LA 71105-5345
(318) 219-6064
(318) 225-7928
Mailing address
1950 E 70TH ST STE A, SHREVEPORT, LA 71105-5345
(318) 219-6064
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6710
LA LICENSE
LA
Enumeration date
02/13/2020
Last updated
02/08/2022
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