Provider Demographics
NPI:1295334704
Name:DUPRE, LAYNE ERICA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAYNE
Middle Name:ERICA
Last Name:DUPRE
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:PO BOX 90245
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70509-0245
Mailing Address - Country:US
Mailing Address - Phone:337-351-4818
Mailing Address - Fax:
Practice Address - Street 1:304 LA RUE FRANCE STE 101
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3136
Practice Address - Country:US
Practice Address - Phone:337-514-7044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty