Individual
LESLIE MIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 BROADMOOR BLVD, LAFAYETTE, LA 70503-5201
(337) 521-7910
(337) 521-7911
Mailing address
401 BROADMOOR BLVD, LAFAYETTE, LA 70503-5201
(337) 521-7910
(337) 521-7911
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5702
LA
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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