Provider Demographics
NPI:1265701510
Name:SEYMOUR, HEATHER DUCOTE (MCD SLP-CCC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:DUCOTE
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:MCD SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 BIRON ST
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-6506
Mailing Address - Country:US
Mailing Address - Phone:985-789-1236
Mailing Address - Fax:
Practice Address - Street 1:2403 BIRON ST
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-6506
Practice Address - Country:US
Practice Address - Phone:985-789-1236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6125235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist