Provider Demographics
NPI:1497403919
Name:DEROCHE, LORALYN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORALYN
Middle Name:
Last Name:DEROCHE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 OAKLAWN DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-4509
Mailing Address - Country:US
Mailing Address - Phone:985-335-0341
Mailing Address - Fax:
Practice Address - Street 1:325 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3009
Practice Address - Country:US
Practice Address - Phone:985-892-4311
Practice Address - Fax:985-871-1480
Is Sole Proprietor?:No
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4033235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist