Provider Demographics
NPI:1285465419
Name:ODOM, MEGHAN (MS, PL-SLP, CF-SLP)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:ODOM
Suffix:
Gender:F
Credentials:MS, PL-SLP, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13909 FLORIDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-6340
Mailing Address - Country:US
Mailing Address - Phone:225-686-4335
Mailing Address - Fax:
Practice Address - Street 1:13327 WILDCAT DR
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:LA
Practice Address - Zip Code:70785
Practice Address - Country:US
Practice Address - Phone:225-665-5534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist