Provider Demographics
NPI:1598955478
Name:PITRE, EMILY VENABLE (MS/SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:VENABLE
Last Name:PITRE
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 CHRISTIE LEE DR
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6896
Mailing Address - Country:US
Mailing Address - Phone:337-654-4832
Mailing Address - Fax:
Practice Address - Street 1:153 CHRISTIE LEE DR
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6896
Practice Address - Country:US
Practice Address - Phone:337-654-4832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5609235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist