Individual
MRS. TRACY SHAVER LAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
206 ALBERT AVE, SHREVEPORT, LA 71105-3006
(318) 455-5806
(318) 868-4772
Mailing address
206 ALBERT AVENUE, SHREVEPORT, LA 71105
(318) 455-5806
(318) 868-4772
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2777
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1-30761-1
—
LA
Enumeration date
04/23/2007
Last updated
07/09/2007
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