Individual
MRS. FREDDY G TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCSLP
Contact information
Practice address
255 W FLORIDA ST, SUITE 200 JEFFERSON SPEECH & LANGUAGE CENTER OF ST TAMM, MANDEVILLE, LA 70448
(985) 626-8403
(985) 727-9871
Mailing address
255 W FLORIDA ST, SUITE 200 JEFFERSON SPEECH & LANGUAGE CENTER OF ST TAMM, MANDEVILLE, LA 70448
(985) 626-8403
(985) 727-9871
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12008332
LA
235Z00000X
Speech-Language Pathologist
4135
LA
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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