Organization
MB THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN BOLTON SLP (OWNER)
(318) 278-0740
Entity
Organization
Contact information
Practice address
5401C JACKSON ST, ALEXANDRIA, LA 71303-2322
(318) 278-0740
Mailing address
5401C JACKSON ST, ALEXANDRIA, LA 71303-2322
(318) 278-0740
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629065
—
LA
Enumeration date
09/22/2014
Last updated
09/22/2014
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