Provider Demographics
NPI:1821330697
Name:GOUVIER, REBECCA HARRELL (M A)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:HARRELL
Last Name:GOUVIER
Suffix:
Gender:F
Credentials:M A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 HATCHER HL
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70803-2606
Mailing Address - Country:US
Mailing Address - Phone:225-578-9054
Mailing Address - Fax:225-578-2995
Practice Address - Street 1:64 HATCHER
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70803-2606
Practice Address - Country:US
Practice Address - Phone:225-578-9054
Practice Address - Fax:225-578-2995
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5440235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist