Provider Demographics
NPI:1568131324
Name:DUPRE, BONNIE JEAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:JEAN
Last Name:DUPRE
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 1:3413 VINCENNES PLACE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-4349
Mailing Address - Country:US
Mailing Address - Phone:504-224-0013
Mailing Address - Fax:
Practice Address - Street 1:3413 VINCENNES PLACE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4349
Practice Address - Country:US
Practice Address - Phone:504-224-0013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8435235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist