Provider Demographics
NPI:1477249720
Name:ST. PIERRE, DARA (SLP)
Entity Type:Individual
Prefix:
First Name:DARA
Middle Name:
Last Name:ST. PIERRE
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 1:1310 S RANGE AVE
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-4810
Mailing Address - Country:US
Mailing Address - Phone:225-380-1894
Mailing Address - Fax:225-380-1896
Practice Address - Street 1:1310 S RANGE AVE
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4810
Practice Address - Country:US
Practice Address - Phone:225-380-1894
Practice Address - Fax:225-380-1896
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9042235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist