Provider Demographics
NPI:1003581729
Name:OBST, DENISE (MCD, CCC, L-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:OBST
Suffix:
Gender:F
Credentials:MCD, CCC, L-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5433 S TONTI ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-4733
Mailing Address - Country:US
Mailing Address - Phone:504-214-7542
Mailing Address - Fax:
Practice Address - Street 1:10001 LAKE FOREST BLVD STE 201
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-6204
Practice Address - Country:US
Practice Address - Phone:504-309-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist