Provider Demographics
NPI:1154039246
Name:ROY, FAITH CHOATE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:CHOATE
Last Name:ROY
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 1:210 MAGNATE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3871
Mailing Address - Country:US
Mailing Address - Phone:337-889-3608
Mailing Address - Fax:
Practice Address - Street 1:210 MAGNATE DR STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3871
Practice Address - Country:US
Practice Address - Phone:337-889-3608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5616235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist