Provider Demographics
NPI:1306590245
Name:POMET, ALLISON (MCD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:POMET
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GUADALUPE ST
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-1008
Mailing Address - Country:US
Mailing Address - Phone:504-462-8601
Mailing Address - Fax:
Practice Address - Street 1:4600 RIVER RD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-1943
Practice Address - Country:US
Practice Address - Phone:504-462-8601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1701033Medicaid