Tanya Beard, CCC-SLP

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

NPI 1780869461 · NPPES record last updated Aug 22, 2019

Key facts

NPI
1780869461
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
8306 (LA)
Practice address
110 Serio Blvd
Ferriday, LA 71334-2013
Phone
(318) 757-8671
NPI assigned
Dec 31, 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

State licenses

LicenseStateTypeSpecialty
8306LAMDProfessional Counselor
S2075MSMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8306 LA Yes
Speech-Language Pathologist 235Z00000X S2075 MS

Addresses

Primary practice location

110 Serio Blvd
Ferriday, LA 71334-2013

Mailing address

117 Belle Chasse Dr
Byram, MS 39212-3162
Phone (601) 668-8772

Other practice location 1

5031 Thornwood Pl
Jackson, MS 39206-3140
Phone (601) 668-8772

Other identifiers

IdentifierTypeStateIssuer
0120389MedicaidMS

Other providers in Ferriday, LA

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

Sources for this page

Verify at the official NPI Registry.