Individual
MRS. KATHRYN LISTI MACICEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC, SLP
Contact information
Practice address
317 BLUEBONNET DR, LAFAYETTE, LA 70508-5412
(337) 288-0808
Mailing address
317 BLUEBONNET DR, LAFAYETTE, LA 70508-5412
(337) 288-0808
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5858
LA
Other
Enumeration date
08/05/2008
Last updated
08/05/2008
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