Provider Demographics
NPI:1487087821
Name:MARSHALL, MEOSHIA MONE'T (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MEOSHIA
Middle Name:MONE'T
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17014 WARRIOR DR.
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE, LA
Mailing Address - State:LA
Mailing Address - Zip Code:70769
Mailing Address - Country:US
Mailing Address - Phone:225-200-5057
Mailing Address - Fax:
Practice Address - Street 1:17014 WARRIOR DR.
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE, LA
Practice Address - State:LA
Practice Address - Zip Code:70769
Practice Address - Country:US
Practice Address - Phone:225-200-5057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6694235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist