Provider Demographics
NPI:1437877099
Name:DELONE, BRENDA FELICIA
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:FELICIA
Last Name:DELONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18333 HIGHWAY 182
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:LA
Mailing Address - Zip Code:70514-1449
Mailing Address - Country:US
Mailing Address - Phone:337-924-7996
Mailing Address - Fax:
Practice Address - Street 1:18333 HIGHWAY 182
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:LA
Practice Address - Zip Code:70514-1449
Practice Address - Country:US
Practice Address - Phone:337-924-7996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3620235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist