Healthcare Provider Details

I. General information

NPI: 1013668623
Provider Name (Legal Business Name): CHELSI DAQUANNO MA, L-SLP, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 WEBSTER ST
DONALDSONVILLE LA
70346-2754
US

IV. Provider business mailing address

1100 WEBSTER ST
DONALDSONVILLE LA
70346-2754
US

V. Phone/Fax

Practice location:
  • Phone: 225-391-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7131
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: