Organization
LAUNCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHANTELLE BALLARD VARNADO PHD, CCC-SLP (EXECUTIVE DIRECTOR)
(225) 405-8627
Entity
Organization
Contact information
Practice address
365 HATCHELL LN., DENHAM SPRINGS, LA 70726
(225) 238-1741
(225) 341-8749
Mailing address
PO BOX 2345, DENHAM SPRINGS, LA 70727-2345
(225) 238-1741
(225) 341-8749
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
4777
LA
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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