Individual
MS. MADISON NICHOLE WIEBELT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
35614 LIBERTY DR, SLIDELL, LA 70460-5840
(985) 641-1901
Mailing address
35614 LIBERTY DR, SLIDELL, LA 70460-5840
(985) 641-1901
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
9447
LA
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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