Organization
THE SPEECH PATHOLOGY CENTER OF LOUISIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONDRA ROSE FAZELY CCC (MEMBER)
(225) 923-1140
Entity
Organization
Contact information
Practice address
8676 GOODWOOD BLVD, SUITE 204, BATON ROUGE, LA 70806-7914
(225) 923-1140
(225) 923-1326
Mailing address
8676 GOODWOOD BLVD, SUITE 204, BATON ROUGE, LA 70806-7914
(225) 923-1140
(225) 923-1326
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2002
LA
Other
Enumeration date
11/07/2006
Last updated
08/22/2020
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