Dejae Jasmin, BS

Individual provider Active NPI Speech-Language Pathologist · Vacherie, LA

NPI 1982170197 · NPPES record last updated Dec 12, 2023

Key facts

NPI
1982170197
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
8041 (LA)
Practice address
3245 Valcour Aime St
Vacherie, LA 70090-7003
Phone
(225) 590-4408
NPI assigned
Oct 16, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
8041LAMDSpeech-Language Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
2355S0801X 8041 LA
Speech-Language Pathologist 235Z00000X 8041 LA Yes

Addresses

Primary practice location

3245 Valcour Aime St
Vacherie, LA 70090-7003

Mailing address

13197 Desire St
Vacherie, LA 70090-4327
Phone (225) 590-4408

Other identifiers

IdentifierTypeStateIssuer
2444557MedicaidLA

Other providers in Vacherie, LA

All providers in Vacherie, LA · Speech-Language Pathologist in Louisiana

Sources for this page

Verify at the official NPI Registry.