Mary C Geno, MS, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Tickfaw, LA

NPI 1215665682 · NPPES record last updated Aug 12, 2022

Key facts

NPI
1215665682
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
1981 (LA)
Practice address
14417 Highway 442 W
Tickfaw, LA 70466-3022
Phone
(985) 345-2166
NPI assigned
Aug 12, 2022
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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1981LAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1981 LA Yes

Addresses

Primary practice location

14417 Highway 442 W
Tickfaw, LA 70466-3022

Mailing address

14417 Highway 442 W
Tickfaw, LA 70466-3022
Phone (985) 345-2166

Other providers in Tickfaw, LA

All providers in Tickfaw, LA · Speech-Language Pathologist in Louisiana

Sources for this page

Verify at the official NPI Registry.