Provider Demographics
NPI:1104002336
Name:HAYES-DEROUEN, JONI L (MED,SLP-A)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:L
Last Name:HAYES-DEROUEN
Suffix:
Gender:F
Credentials:MED,SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2383 WOODBEND DR
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2784
Mailing Address - Country:US
Mailing Address - Phone:225-955-2204
Mailing Address - Fax:
Practice Address - Street 1:2383 WOODBEND DR
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2784
Practice Address - Country:US
Practice Address - Phone:225-955-2204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA55172355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant