Individual
MADISYN WASCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L-SLP, CCC-SLP
Contact information
Practice address
13909 FLORIDA BLVD, LIVINGSTON, LA 70754-6340
(225) 686-4319
Mailing address
13909 FLORIDA BLVD, LIVINGSTON, LA 70754-6340
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8882
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8882
LBESPA
—
Enumeration date
08/06/2021
Last updated
05/07/2024
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