MEDICARE: ABIGAIL NAQUIN COURVILLE MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7894	LA

General Provider Information

NPI Number	:	1003484353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL NAQUIN COURVILLE MS, CCC-SLP

Provider Business Mailing Address
First Line	:	102 CRANBERRY DR
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-9101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 S MARTIN LUTHER KING JR DR
Second Line	:
City	:	SAINT MARTINVILLE
State	:	LA
Zip	:	70582-3128
Country	:	US
Telephone Number	:	337-909-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2021
Last Update Date	:	01/07/2024

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