Provider Demographics
NPI:1134991672
Name:HEBERT, STEPHANIE N (MED, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:N
Last Name:HEBERT
Suffix:
Gender:F
Credentials:MED, CCC/SLP
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:HEBERT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, CCC/SLP
Mailing Address - Street 1:6977 W T HALL RD
Mailing Address - Street 2:
Mailing Address - City:ETHEL
Mailing Address - State:LA
Mailing Address - Zip Code:70730-4330
Mailing Address - Country:US
Mailing Address - Phone:225-324-0894
Mailing Address - Fax:
Practice Address - Street 1:4200 ROLLINS RD
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2945
Practice Address - Country:US
Practice Address - Phone:225-358-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3621235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist