Individual
MALLARY NOCOLE VENABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1034 MAIN ST, PARKS, LA 70582-6639
(337) 845-4663
Mailing address
103 CANE HILL DR, BROUSSARD, LA 70518-7459
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9648
LA
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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