Individual
SAMANTHA ELIZABETH MIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1805 COLLEGE DR, BATON ROUGE, LA 70808-1919
(225) 923-3420
(225) 922-9316
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 923-3420
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9104
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
Enumeration date
06/21/2022
Last updated
06/22/2022
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