Individual
KILEY BERNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1715 VIOLA ST, MANDEVILLE, LA 70448-8609
(985) 674-3011
Mailing address
703 SWEET BAY DR, MANDEVILLE, LA 70448-6277
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4471
LA
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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