Provider Demographics
NPI:1821341462
Name:DUPUY, JOAN RENEE (AUD)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:RENEE
Last Name:DUPUY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 US HIGHWAY 70 W
Mailing Address - Street 2:STE 103
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4531
Mailing Address - Country:US
Mailing Address - Phone:252-773-0636
Mailing Address - Fax:877-771-3406
Practice Address - Street 1:18518 HARDY OAK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4762
Practice Address - Country:US
Practice Address - Phone:210-696-4327
Practice Address - Fax:210-798-2509
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81014231H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program