Provider Demographics
NPI:1932765401
Name:EARNEST, CURTISTINE LOUANN (MCD, CCC, SLP)
Entity Type:Individual
Prefix:MS
First Name:CURTISTINE
Middle Name:LOUANN
Last Name:EARNEST
Suffix:
Gender:F
Credentials:MCD, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6117 VERONA LN
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4831
Mailing Address - Country:US
Mailing Address - Phone:318-868-0132
Mailing Address - Fax:
Practice Address - Street 1:6117 VERONA LN
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4831
Practice Address - Country:US
Practice Address - Phone:318-868-0132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA931235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist