Doctor Name: | MRS. CORI D. DYSART GAGNARD |
NPI Number: | 1285841551 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | 5582 |
Business Practice Address: | 24265 Cane Byu Lacombe, LA - 704456125 |
Business Phone Number: | 9858694183 |
Business Fax Number: | 9858982940 |
Mailing Address: | 309 Swift Fox Run, MADISONVILLE |
State: | LA |
Postal Code: | 704473113 |
Phone Number: | 5042366810 |
Fax Number: | 9857925305 |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | 5582 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |