Provider Demographics
NPI:1861698094
Name:THE SPEECH LADY
Entity type:Organization
Organization Name:THE SPEECH LADY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA-CCC-SLP
Authorized Official - Phone:318-614-7400
Mailing Address - Street 1:121 JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-1615
Mailing Address - Country:US
Mailing Address - Phone:318-614-7400
Mailing Address - Fax:318-410-4351
Practice Address - Street 1:121 JORDAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-1615
Practice Address - Country:US
Practice Address - Phone:318-614-7400
Practice Address - Fax:318-410-4351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3462235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4394538190OtherBLUE CROSS
LA=========OtherSTATE EMPLOYEES