Organization Name: | SYNERGY CARE SOUTHEAST LLC |
NPI Number: | 1073852075 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD BROUSSARD (CONTROLLER) |
Mailing Address: | 127 W Broad St Lake Charles |
State: | LA US |
Postal Code: | 706014291 |
Phone Number: | 3373108500 |
Fax Number: | 8882413028 |
NPI Enumeration Date: | 02/11/2013 |
NPI Last Update Date: | 07/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |