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
| License | State | Type | Specialty |
|---|---|---|---|
| 8041 | LA | MD | Speech-Language Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2444557 | Medicaid | LA |
Other providers in Vacherie, LA
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- Govanna Gaudia
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- Greater Grace Charter Academy Inc
- Kasia Harry
- Wayne M. Kliebert
- Joy Elizabeth Labat
- Amy H Lagraize
- Lynsey Landry
- Emily Ann Earline Lassere
All providers in Vacherie, LA · Speech-Language Pathologist in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.