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NPI Code Detail

MEDICARE: DEVANNE BRANDI SOURS

MEDICARE: DEVANNE BRANDI SOURS
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
1235Z00000XSpeech-Language Pathologist8526LA

General Provider Information

NPI Number : 1710652508
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVANNE BRANDI SOURS
Provider Business Mailing Address
First Line : 810 EUTERPE ST APT 9109
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70130-8626
Country : US
Telephone Number : 575-399-8831
Fax Number :
Provider Business Practice Location Address
First Line : 810 EUTERPE ST APT 9109
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70130-8626
Country : US
Telephone Number : 575-399-8831
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2021
Last Update Date : 08/12/2021

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Directions to “ DEVANNE BRANDI SOURS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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