Foundations Pediatric Center LLC
Speech-Language Pathologist, in Lake Charles, LA. Organization (NPI-2).
NPI number1942069737
StatusActive
Last updated in NPPESAug 16, 2024
Details
- NPI
- 1942069737
- Entity type
- Organization (NPI-2)
- Legal business name
- Foundations Pediatric Center LLC
- Organization subpart
- No
- Enumeration date
- Mar 15, 2024
- Certification date
- Aug 16, 2024
- Last updated
- Aug 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | – | – | Yes |
Practice location
4300 Lake StLake Charles, LA 70605
Phone 337-304-9391
Mailing address
4330 Lake StLake Charles, LA 70605-4310
Phone 337-429-5083
Authorized official
Jessica Pardo
Owner/Partner
3373049391
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