Provider Demographics
NPI:1295925394
Name:EXPRESS YOURSELF SPEECH AND LANGUAGE THERAPY,LLC
Entity type:Organization
Organization Name:EXPRESS YOURSELF SPEECH AND LANGUAGE THERAPY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DIONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-SLP
Authorized Official - Phone:985-532-8936
Mailing Address - Street 1:227 E TWELFTH ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:LA
Mailing Address - Zip Code:70374-2667
Mailing Address - Country:US
Mailing Address - Phone:985-532-8936
Mailing Address - Fax:985-532-8936
Practice Address - Street 1:227 E TWELFTH ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:LA
Practice Address - Zip Code:70374-2667
Practice Address - Country:US
Practice Address - Phone:985-532-8936
Practice Address - Fax:985-532-8936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2009-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty