Organization
AMPHD THERAPEUTIC CONNECTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALISA K. MENDOZA PH.D. (OWNER/SPEECH PATHOLOGIST)
(225) 278-8919
Entity
Organization
Contact information
Practice address
16172 AIRLINE HWY, PRAIRIEVILLE, LA 70769-4212
(225) 278-8919
Mailing address
37406 PROVENCE POINTE AVE, PRAIRIEVILLE, LA 70769-4397
(225) 278-8919
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
3013
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1300071
—
LA
Enumeration date
11/15/2017
Last updated
06/16/2018
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