Provider Demographics
NPI:1528200342
Name:BOSSIER, LAURENE' ANDREE' (SLP)
Entity Type:Individual
Prefix:MS
First Name:LAURENE'
Middle Name:ANDREE'
Last Name:BOSSIER
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 1:162 SOUTH CONCORD ROAD
Mailing Address - Street 2:APT. A
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037
Mailing Address - Country:US
Mailing Address - Phone:504-912-0117
Mailing Address - Fax:
Practice Address - Street 1:162 SOUTH CONCORD ROAD
Practice Address - Street 2:APT. A
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037
Practice Address - Country:US
Practice Address - Phone:504-912-0117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist