Provider Demographics
NPI:1093998924
Name:DUGAS, JEAN ANN (MS , CCC-A)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:ANN
Last Name:DUGAS
Suffix:
Gender:F
Credentials:MS , CCC-A
Other - Prefix:MRS
Other - First Name:JEAN
Other - Middle Name:KLAR
Other - Last Name:DUGAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:7520 MONTGOMERY BLVD NE BLDG E15
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1586
Mailing Address - Country:US
Mailing Address - Phone:505-872-4327
Mailing Address - Fax:505-872-1041
Practice Address - Street 1:7520 MONTGOMERY BLVD NE BLDG E15
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1586
Practice Address - Country:US
Practice Address - Phone:505-872-4327
Practice Address - Fax:505-872-1041
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM271237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000K2020Medicaid
NM000K2020Medicaid