Provider Demographics
NPI:1104461219
Name:HOWARD, MADALYN O (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MADALYN
Middle Name:O
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 FORE RD
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:LA
Mailing Address - Zip Code:71435-3619
Mailing Address - Country:US
Mailing Address - Phone:318-805-1236
Mailing Address - Fax:
Practice Address - Street 1:7726 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3322
Practice Address - Country:US
Practice Address - Phone:318-649-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-12
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8327235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist