Individual
LISA D PINELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
741 BAYOU RD, SUITE A, THIBODAUX, LA 70301-2461
(985) 209-1600
Mailing address
110 ELM ST, THIBODAUX, LA 70301-2413
(985) 209-1600
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LA 3067
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306215
—
LA
Enumeration date
12/31/2006
Last updated
03/08/2013
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