MEDICARE: MISS JENNIFER BROOKE CHAUVIN MCD, 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	5566	LA

General Provider Information

NPI Number	:	1154529808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNIFER BROOKE CHAUVIN MCD, CCC-SLP

Provider Business Mailing Address
First Line	:	315 E WILLIAM DAVID PKWY
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70005-3309
Country	:	US
Telephone Number	:	504-258-5521
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 PLANTATION RD
Second Line	:
City	:	DESTREHAN
State	:	LA
Zip	:	70047-3013
Country	:	US
Telephone Number	:	985-764-9348
Fax Number	:

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

Provider Enumeration Date	:	07/04/2007
Last Update Date	:	07/10/2023

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