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Individual

PAIGE KELLEY KASSAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
821 N BURNSIDE AVE, GONZALES, LA 70737-2835
(225) 647-3704
Mailing address
40157 LA ROCHELLE RD, PRAIRIEVILLE, LA 70769-5343
(318) 787-1536

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8826
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010874823
DRIVER'S LICENSE NUMBER
LA
Enumeration date
07/14/2022
Last updated
07/14/2022
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