Individual
ELLIE PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
335 WOODS RD, RUSTON, LA 71270-7148
(318) 533-6000
Mailing address
335 WOODS RD, RUSTON, LA 71270-7148
(318) 533-6000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7097
LA
Other
Enumeration date
01/12/2024
Last updated
01/12/2024
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