MEDICARE: BONNIE JEAN DUPRE M.S., 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	8435	LA

General Provider Information

NPI Number	:	1568131324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE JEAN DUPRE M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	3413 VINCENNES PLACE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-4349
Country	:	US
Telephone Number	:	504-224-0013
Fax Number	:

Provider Business Practice Location Address
First Line	:	3413 VINCENNES PLACE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70125-4349
Country	:	US
Telephone Number	:	504-224-0013
Fax Number	:

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

Provider Enumeration Date	:	09/07/2021
Last Update Date	:	09/07/2021

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Directions to “ BONNIE JEAN DUPRE M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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