MEDICARE: MS. DENISE DUGAS TAYLOR M.A., 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	871	LA

General Provider Information

NPI Number	:	1699825455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENISE DUGAS TAYLOR M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	609 K ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-4717
Country	:	US
Telephone Number	:	318-362-0117
Fax Number	:	318-387-5623

Provider Business Practice Location Address
First Line	:	2802 KILPATRICK BLVD
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-5139
Country	:	US
Telephone Number	:	318-362-0117
Fax Number	:	318-387-5623

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	07/08/2007

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