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Individual

JESSICA PARDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1727 IMPERIAL BLVD BLDG 3, LAKE CHARLES, LA 70605-5362
(337) 478-5880
(337) 478-5879
Mailing address
1727 IMPERIAL BLVD BLDG 3, LAKE CHARLES, LA 70605-5362
(337) 478-5880
(337) 478-5879

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7932
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7932
SPEECH-LANGUAGE PATHOLOGY
LA
Enumeration date
04/12/2018
Last updated
04/12/2018
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