Cori D. Dysart Gagnard, M.ED.

Individual provider Active NPI Speech-Language Assistant · Lacombe, LA

NPI 1285841551 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1285841551
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Assistant 2355S0801X
License
5582 (LA)
Practice address
24265 Cane Byu
Lacombe, LA 70445-6125
Phone
(985) 869-4183
Fax
(985) 898-2940
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
Yes

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 Education

State licenses

LicenseStateTypeSpecialty
5582LAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 5582 LA Yes

Addresses

Primary practice location

24265 Cane Byu
Lacombe, LA 70445-6125

Mailing address

309 Swift Fox Run
Madisonville, LA 70447-3113
Phone (504) 236-6810

Other identifiers

IdentifierTypeStateIssuer
1527807MedicaidLA

Other providers in Lacombe, LA

All providers in Lacombe, LA · Speech-Language Assistant in Louisiana

Sources for this page

Verify at the official NPI Registry.