Organization
PEDIATRIC THERAPY OF LOUISIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALISA TRAHAN M.A., CCC-SLP (OWNER)
(337) 540-1861
Entity
Organization
Contact information
Practice address
4106 MAID STONE DR, LAKE CHARLES, LA 70605-4030
(337) 540-1861
Mailing address
4106 MAID STONE DR, LAKE CHARLES, LA 70605-4030
(337) 540-1861
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
LA
252Y00000X
Early Intervention Provider Agency
—
LA
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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