Phyllis Jackson, S.T.
Individual provider Active NPI Speech-Language Pathologist · Walker, LA
NPI 1154473684 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154473684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 941 (LA)
- Practice address
- 9384 Florida Boulevard
Suite F
Walker, LA 70785 - Phone
- (225) 791-0911
- Fax
- (225) 791-1977
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brignac Physical Therapy, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 941 | LA | Yes |
Addresses
Primary practice location
9384 Florida Boulevard
Suite F
Walker, LA 70785
Mailing address
9384 Florida Boulevard
Suite F
Walker, LA 70785
Phone (225) 791-0911
Other providers in Walker, LA
- Infinity Personal Care
- Infinity Personal Care, Inc
- Infinity Personal Care, Inc
- Emily Patrice Irvin
- Jack R Reid Jr MD LLC
- Cheryl Jeane
- Nicole Futch Jenks
- Hannah Jones
- Shyanne Rainelle Jones
- Kori Fogg Juban
All providers in Walker, 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 Jul 8, 2007. 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.