Provider Demographics
NPI:1508596057
Name:DEVELLE, JEANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:DEVELLE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:
Other - Last Name:DEVELLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:500 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-6072
Mailing Address - Country:US
Mailing Address - Phone:323-252-5439
Mailing Address - Fax:
Practice Address - Street 1:500 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-6072
Practice Address - Country:US
Practice Address - Phone:323-252-5439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8115235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist