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1801358270
ETHAN HYATT
LAKE CHARLES, LA
NPI
1801358270
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: LA 8106)
Enumeration Date
2019-04-03
Last Update Date
2019-04-03
Business Address
ETHAN HYATT SLP
1727 IMPERIAL BLVD BLDG 3
LAKE CHARLES, LA 70605-5393
Phone number: 337-478-5880
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Mailing Address
ETHAN HYATT SLP
1727 IMPERIAL BLVD BLDG 3
LAKE CHARLES, LA 70605-5393
Phone number: 337-478-5880
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