Ty Marie Wingate
Individual provider Active NPI Speech-Language Pathologist · Duson, LA
NPI 1033054804 · NPPES record last updated Apr 20, 2026
Key facts
- NPI
- 1033054804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 9576 (LA)
- Practice address
- 2845 Ridge Rd
Duson, LA 70529-3939 - Phone
- (337) 521-7630
- NPI assigned
- Apr 20, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9576 | LA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 9576 | LA | Yes |
Addresses
Primary practice location
2845 Ridge Rd
Duson, LA 70529-3939
Mailing address
2845 Ridge Rd
Duson, LA 70529-3939
Phone (337) 521-7630
Other providers in Duson, LA
- Madelyn Isabella Stoute
- Tiffany Roy FNP LLC
- Tiffany Roy, FNP, L.L.C.
- Timeless Love Journey Doula
- Shelly Trahan
All providers in Duson, LA · Speech-Language Pathologist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.