Provider Demographics
NPI:1881090512
Name:SPEYRER, DOREEN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:
Last Name:SPEYRER
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 1358
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70063-1358
Mailing Address - Country:US
Mailing Address - Phone:504-250-9043
Mailing Address - Fax:
Practice Address - Street 1:4608 PERRY DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2018
Practice Address - Country:US
Practice Address - Phone:504-250-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4642235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist