Individual
NICOLE GRAUGNARD LAROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1808 BAYOU RD, THIBODAUX, LA 70301-6034
(985) 497-3224
Mailing address
PO BOX 5, EDGARD, LA 70049-0005
(985) 497-3224
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3254
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1409405
—
LA
Enumeration date
05/26/2007
Last updated
07/08/2007
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