Marissa Munn Mouledous, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8000 Issued in LA

Practice address

612 Holy Trinity Dr
Covington, LA 70433

Phone

(985) 643-5630

NPI assigned

Nov 24, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1467056150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 KNOLL PINE CIR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704355615",
            "telephone_number": "318-376-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 HOLY TRINITY DR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "70433",
            "telephone_number": "985-643-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULEDOUS",
        "first_name": "MARISSA",
        "middle_name": "MUNN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "8000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Mouser Morton, MSW
• Matthew Duke Morvant, PHARM. D.
• Jonathan Brent Moss, M.D.
• Regina Ongsing Moss, NP, RN
• Ashley Martin Mossbarger, APRN, FNP-C
• Moving and Caring Transportation LLC
• Rachel Mudge, MD
• Nancy Mula, M.D.
• Carissa Muller, FNP-C
• Charles David Muntan, MD

• Speech-Language Pathologist in Covington, LA
• Providers in Covington, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.