Provider Demographics
NPI:1285961862
Name:ABBEVILLE HEARING AND SPEECH ASSOCIATES,INC
Entity type:Organization
Organization Name:ABBEVILLE HEARING AND SPEECH ASSOCIATES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DUCOTE
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:337-898-2742
Mailing Address - Street 1:401 N SAINT CHARLES ST
Mailing Address - Street 2:BLDG B
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-4770
Mailing Address - Country:US
Mailing Address - Phone:337-898-2742
Mailing Address - Fax:337-898-2660
Practice Address - Street 1:401 N SAINT CHARLES ST
Practice Address - Street 2:BLDG B
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4770
Practice Address - Country:US
Practice Address - Phone:337-898-2742
Practice Address - Fax:337-898-2660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA569235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1329363Medicaid