Provider Demographics
NPI:1699825455
Name:TAYLOR, DENISE DUGAS (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:DUGAS
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 K ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-4717
Mailing Address - Country:US
Mailing Address - Phone:318-362-0117
Mailing Address - Fax:318-387-5623
Practice Address - Street 1:2802 KILPATRICK BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5139
Practice Address - Country:US
Practice Address - Phone:318-362-0117
Practice Address - Fax:318-387-5623
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist