Provider Demographics
NPI:1245622067
Name:BHAKTA, DIPALI PATEL (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DIPALI
Middle Name:PATEL
Last Name:BHAKTA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:962 TOMMY MUNRO DR STE A
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2139
Mailing Address - Country:US
Mailing Address - Phone:301-200-1789
Mailing Address - Fax:
Practice Address - Street 1:962 TOMMY MUNRO DR STE A
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2139
Practice Address - Country:US
Practice Address - Phone:601-775-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08724235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD844348796Medicaid