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General NPI Number Information
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NPI Number | 1457771198
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Entity Type | Individual
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Provider Name | JENNIFER HINES DANIEL MCD, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 4515 EDDIE WILLIAMS AVE
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City | ALEXANDRIA
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State | LA
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Zip | 71302-3628
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Country | US
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Telephone | 318-442-5731
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Fax |
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Provider Business Mailing Address
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Address Line | 225 ADAMS PATH
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City | PINEVILLE
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State | LA
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Zip | 71360-7904
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Country | US
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Telephone | 318-419-8177
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 6539
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License Number State | LA
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