Provider Demographics
NPI:1134796568
Name:VERDIN, KELSEY ALEXIS
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ALEXIS
Last Name:VERDIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 GRAND CAILLOU RD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70363-7198
Mailing Address - Country:US
Mailing Address - Phone:985-647-9185
Mailing Address - Fax:
Practice Address - Street 1:1054 CANAL BLVD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4544
Practice Address - Country:US
Practice Address - Phone:985-665-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9518235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist