Individual
STEPHANIE DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1325 LOUISVILLE AVE, MONROE, LA 71201-6021
(318) 807-1500
(318) 807-1504
Mailing address
130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 812-6603
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6088
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2367722
—
LA
Enumeration date
05/06/2014
Last updated
02/02/2015
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