Provider Demographics
NPI:1467327247
Name:PISTORIUS, MAEGAN (MCD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MAEGAN
Middle Name:
Last Name:PISTORIUS
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:MAEGAN
Other - Middle Name:
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCD, CCC-SLP
Mailing Address - Street 1:2529 JENA ST # 104
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-6322
Mailing Address - Country:US
Mailing Address - Phone:504-688-3568
Mailing Address - Fax:
Practice Address - Street 1:2529 JENA ST # 104
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6322
Practice Address - Country:US
Practice Address - Phone:504-688-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6673235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist