Provider Demographics
NPI:1437800190
Name:FOLSE, ALINE GRAVOIS (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALINE
Middle Name:GRAVOIS
Last Name:FOLSE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13693 HIGHWAY 643
Mailing Address - Street 2:
Mailing Address - City:VACHERIE
Mailing Address - State:LA
Mailing Address - Zip Code:70090-3256
Mailing Address - Country:US
Mailing Address - Phone:225-931-8742
Mailing Address - Fax:
Practice Address - Street 1:110 BOWIE RD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6703
Practice Address - Country:US
Practice Address - Phone:985-447-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5187235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist