Individual
MELANIE BAKER RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1325 S MORGAN AVE, BROUSSARD, LA 70518-5121
(337) 521-7870
Mailing address
105 JOURNEY LN, LAFAYETTE, LA 70506-6655
(337) 212-5921
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6925
LA
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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